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General NPI Number Information
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NPI Number | 1922217116
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Entity Type | Individual
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Provider Name | ANNETTE FORNOS M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 10/13/2015
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Provider Practice Location Address
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Address Line | 8746 SW 24 ST
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City | MIAMI
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State | FL
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Zip | 33165-2006
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Country | US
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Telephone | 305-823-3312
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Fax | 305-884-3989
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Provider Business Mailing Address
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Address Line | 167W 23RD ST
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City | HIALEAH
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State | FL
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Zip | 33010-2211
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Country | US
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Telephone | 305-823-3312
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Fax | 305-884-3989
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME102339
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License Number State | FL
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