Healthcare Provider Details
I. General information
NPI: 1992712913
Provider Name (Legal Business Name): LLORET FIALKOW & GOMEZ MDS PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7400 SW 87TH AVE SUITE 100
MIAMI FL
33173
US
IV. Provider business mailing address
7400 SW 87TH AVE SUITE 100
MIAMI FL
33173
US
V. Phone/Fax
- Phone: 305-275-8200
- Fax: 305-274-7812
- Phone: 305-275-8200
- Fax: 305-274-7812
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RAMON
LUIS
LLORET
Title or Position: PRESIDENT
Credential: MD
Phone: 305-275-8200