Healthcare Provider Details

I. General information

NPI: 1912914003
Provider Name (Legal Business Name): DORIS CIFUENTES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 02/03/2022
Certification Date: 02/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21110 BISCAYNE BLVD STE 203
AVENTURA FL
33180-1251
US

IV. Provider business mailing address

PO BOX 4189
DEERFIELD BEACH FL
33442-4189
US

V. Phone/Fax

Practice location:
  • Phone: 305-948-9595
  • Fax: 305-948-9292
Mailing address:
  • Phone: 561-406-6064
  • Fax: 954-406-6073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME136939
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: