Daniel J Basulto, MD
Individual provider Active NPI General Practice Physician · Surfside, FL
NPI 1962413385 · NPPES record last updated Apr 21, 2026
Key facts
- NPI
- 1962413385
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- ME81034 (FL)
- Practice address
- 9208 Harding Ave
Surfside, FL 33154-3010 - Phone
- (786) 252-8261
- NPI assigned
- Aug 10, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME81034 | FL | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vega Health Center Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | ME81034 | FL | Yes |
Addresses
Primary practice location
9208 Harding Ave
Surfside, FL 33154-3010
Mailing address
9208 Harding Ave
Surfside, FL 33154-3010
Phone (786) 252-8261
Other providers in Surfside, FL
- Anabella Allocco
- Arlene Amargos
- Ams Anesthesia LLC
- Kayla Tiferet Azari Garmizo
- George Bard
- Rachel Baum
- Annabella C Bazante
- Yudah Ari Benmergui
- Amy Blumenthal
- Maria Jose Bucarelo
All providers in Surfside, FL · General Practice Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 21, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.