MEDICARE: DR. FAZLE YUSUFALI DALAL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	D7743	TX

General Provider Information

NPI Number	:	1497795033
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FAZLE YUSUFALI DALAL MD

Provider Business Mailing Address
First Line	:	1000 VENETIAN WAY
Second Line	:	# 1604
City	:	MIAMI
State	:	FL
Zip	:	33139-1009
Country	:	US
Telephone Number	:	305-377-2600
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 VENETIAN WAY
Second Line	:	# 1604
City	:	MIAMI
State	:	FL
Zip	:	33139-1032
Country	:	US
Telephone Number	:	305-377-2600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	07/08/2007

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