Healthcare Provider Details

I. General information

NPI: 1104029404
Provider Name (Legal Business Name): VICTORIA FIERRO MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2007
Last Update Date: 07/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10200 NW 25TH ST SUITE 106
DORAL FL
33172-5921
US

IV. Provider business mailing address

10200 NW 25TH ST SUITE 106
DORAL FL
33172-5921
US

V. Phone/Fax

Practice location:
  • Phone: 786-336-0300
  • Fax: 786-336-0332
Mailing address:
  • Phone: 786-336-0300
  • Fax: 786-336-0332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME77153
License Number StateFL

VIII. Authorized Official

Name: DR. VICTORIA H FIERRO-COBAS
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 786-336-0300