Individual provider Active NPI

Eddy Dalus, LMT

  • Health Information Specialist/Technologist
  • Wilton Manors, FL
National Provider Identifier
1508923046
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Information Specialist/TechnologistTaxonomy code 246Y00000X
License
MA26581 Issued in FL
Practice address
2713 N Andrews Ave
Wilton Manors, FL 33311-2511
Phone
(954) 568-5252
Fax
(954) 568-6833
NPI assigned
Jan 3, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Information Specialist/Technologist 246Y00000X MA26581 FL Primary

Addresses

Primary practice location

2713 N Andrews Ave
Wilton Manors, FL 33311-2511

Mailing address

4816 NW 14TH St
Coconut Creek, FL 33063-3956
Phone (954) 383-9430

Other identifiers 1

IdentifierTypeStateIssuer
MA26581OtherFLLICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MA26581FLMDHealth Information Specialist/Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Natural Healthcare Clinic Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508923046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4816 NW 14TH ST",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330633956",
            "telephone_number": "954-383-9430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2713 N ANDREWS AVE",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333112511",
            "telephone_number": "954-568-5252",
            "fax_number": "954-568-6833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALUS",
        "first_name": "EDDY",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246Y00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Health Information",
            "state": "FL",
            "license": "MA26581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "MA26581",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilton Manors, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.