Healthcare Provider Details

I. General information

NPI: 1841225752
Provider Name (Legal Business Name): MICHAEL REMALY DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 03/19/2021
Certification Date: 03/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 WASHINGTON ST
HOLLYWOOD FL
33021-8216
US

IV. Provider business mailing address

PO BOX 863481
ORLANDO FL
32886-3481
US

V. Phone/Fax

Practice location:
  • Phone: 954-966-4500
  • Fax: 904-346-0113
Mailing address:
  • Phone: 954-563-8332
  • Fax: 904-346-0113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberOS0009468
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: