Provider Demographics
NPI:1649313115
Name:BOTOMAN, DANIELA ANCA (MD)
Entity type:Individual
Prefix:DR
First Name:DANIELA
Middle Name:ANCA
Last Name:BOTOMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5100 COCONUT CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-3913
Mailing Address - Country:US
Mailing Address - Phone:954-281-7700
Mailing Address - Fax:954-715-7603
Practice Address - Street 1:5100 COCONUT CREEK PKWY
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-3913
Practice Address - Country:US
Practice Address - Phone:954-281-7700
Practice Address - Fax:954-715-7603
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL74471207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL018673000Medicaid
FL49631WMedicare PIN
FL018673000Medicaid