Daniel Ettedgui, D.O. PA

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

OS-6221 Issued in FL

Legal business name

DANIEL ETTEDGUI, D.O. PA

Practice address

1905 Clint Moore Road
Suite 308
Boca Raton, FL 33496-2658

Phone

(561) 912-9580

Fax

(561) 912-9506

NPI assigned

Oct 24, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Flori F McGinty

Title

Practice Administrator

Phone

(561) 912-9580

Specialties & licenses 2

Addresses

Other names 1

• Physical Medicine of South Florida Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Daniel Ettedgui, D.O.

  • Physical Medicine & Rehabilitation Physician
  • Boca Raton, FL
  • NPI 1972572246
  Medicare reassignment NPD
• Sarah Elizabeth Beatty, PA-C

  • Physician Assistant
  • Greensboro, NC
  • NPI 1396237566

  FL

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334275200000",
    "number": "1265516611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 CLINT MOORE ROAD",
            "address_2": "SUITE 308",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "33496",
            "telephone_number": "561-912-9580",
            "fax_number": "561-912-9506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 CLINT MOORE ROAD",
            "address_2": "SUITE 308",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334962658",
            "telephone_number": "561-912-9580",
            "fax_number": "561-912-9506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL ETTEDGUI, D.O. PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2012-04-13",
        "status": "A",
        "authorized_official_last_name": "MCGINTY",
        "authorized_official_first_name": "FLORI",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "561-912-9580",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "OS-6221",
            "primary": true
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "FL",
            "license": "OS6221",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Physical Medicine of South Florida",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica Erin Danegelis, RMHCI
• Ali Asghar Danesh, PHD, MS, BSC
• Farzon Danesh, AUD
• Daniel & Max
• Daniel E Gewartowski DDS PA
• Daniel Lobovits, PH.D., P.a.
• Daniel Ohara M D P a
• Daniel R. Deakter, M.D.PA
• Daniel S. Kovacs, M.D., P.a.
• Daniela a Tudoran,DDS and Timothy M. Viner, DDS, PA

• Physical Medicine & Rehabilitation Physician in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Physical Medicine & Rehabilitation Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.