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General NPI Number Information
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NPI Number | 1386949345
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Entity Type | Organization
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Legal Business Name | ELIAS A M FEANNY MD PA
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Dates
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Enumeration Date | 01/21/2011
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Last Update Date | 08/20/2013
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Provider Practice Location Address
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Address Line | 9275 SW 152 STREET SUITE 101
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City | MIAMI
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State | FL
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Zip | 33157
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Country | US
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Telephone | 305-253-8869
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Fax | 305-233-9726
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Provider Business Mailing Address
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Address Line | 9275 SW 152ND ST SUITE 101
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City | PALMETTO BAY
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State | FL
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Zip | 33157-1701
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Country | US
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Telephone | 305-253-8869
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Fax | 305-233-9726
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | DR. ELIAS ANTHONY FEANNY
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Credential | M.D.
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Telephone | 305-253-8869
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME76407
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License Number State | FL
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