Healthcare Provider Details

I. General information

NPI: 1699812560
Provider Name (Legal Business Name): DOROTHY VIOLA STRAW M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 08/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 S HOSPITAL DR STE 110
PLANTATION FL
33317-2813
US

IV. Provider business mailing address

4100 NW 3RD CT STE 110
PLANTATION FL
33317-2813
US

V. Phone/Fax

Practice location:
  • Phone: 954-584-8222
  • Fax: 954-584-8224
Mailing address:
  • Phone: 954-584-8222
  • Fax: 954-584-8224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME0045637
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: