MEDICARE: MRS. MARIA TERESA FALEN 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
1	208D00000X	General Practice Physician	ME 90697	FL

General Provider Information

NPI Number	:	1205889854
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARIA TERESA FALEN M.D.

Provider Business Mailing Address
First Line	:	17190 SW 94TH AVE
Second Line	:	APT N' 906
City	:	VILLAGE OF PALMETTO BAY
State	:	FL
Zip	:	33157-4445
Country	:	US
Telephone Number	:	305-801-8276
Fax Number	:	305-255-3973

Provider Business Practice Location Address
First Line	:	3271 NW 7TH ST
Second Line	:	SUITE 202
City	:	MIAMI
State	:	FL
Zip	:	33125-4141
Country	:	US
Telephone Number	:	305-253-1660
Fax Number	:	305-253-5775

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	07/09/2007

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