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General NPI Number Information
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NPI Number | 1619921962
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Entity Type | Individual
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Provider Name | DALE E FAHIE D.O.F.A.C.O.F.P.
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Gender | Male
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Dates
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Enumeration Date | 05/20/2006
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Last Update Date | 02/06/2013
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Provider Practice Location Address
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Address Line | 4600 NORTH FEDERAL HIGHWAY FOY'S MEDICAL CENTER
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-5206
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Country | US
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Telephone | 954-202-9948
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Fax | 954-202-7399
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Provider Business Mailing Address
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Address Line | 17320 SW 32ND CT
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City | MIRAMAR
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State | FL
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Zip | 33029-5591
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Country | US
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Telephone | 954-202-9948
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Fax | 954-202-7399
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS-06925
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207QA0000X
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Taxonomy Name | Adolescent Medicine (Family Medicine) Physician
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License Number | OS-6925
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | OS-6925
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | OS-6925
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License Number State | FL
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