Basic Information
| Provider Information | |||||||||
| NPI: | 1548562051 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BOLET | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | EDUARDO | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1500 NW 12TH AVE STE 810 | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331361037 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055856649 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3801 BISCAYNE BLVD | ||||||||
| Address2: | SUITE 230 | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331379800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7864668490 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/03/2010 | ||||||||
| LastUpdateDate: | 09/19/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | ME117082 | FL | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.