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NPI Code Detail

MEDICARE: RAYMUND M DALA M.D.

MEDICARE: RAYMUND M DALA M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ZP0102XAnatomic Pathology & Clinical Pathology PhysicianME92580FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
113268OTHERFLBCBS OF FLORIDA
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154420446
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAYMUND M DALA M.D.
Provider Business Mailing Address
First Line : PO BOX 741087
Second Line :
City : ATLANTA
State : GA
Zip : 30374-1087
Country : US
Telephone Number : 954-475-4386
Fax Number : 954-475-5891
Provider Business Practice Location Address
First Line : 3476 S UNIVERSITY DR
Second Line :
City : DAVIE
State : FL
Zip : 33328-2000
Country : US
Telephone Number : 954-475-4386
Fax Number : 954-475-5891
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2006
Last Update Date : 08/20/2024

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