MEDICARE: MARIANA DOVAL 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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	036175455	IL
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	ME72281	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00380841	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770566143
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIANA DOVAL M.D.

Provider Business Mailing Address
First Line	:	2030 W MCNAB RD
Second Line	:	# 2
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33309-1002
Country	:	US
Telephone Number	:	561-633-1000
Fax Number	:	561-633-1024

Provider Business Practice Location Address
First Line	:	10101 FOREST HILL BLVD
Second Line	:	PATHOLOGY DEPT.
City	:	WELLINGTON
State	:	FL
Zip	:	33414-6103
Country	:	US
Telephone Number	:	561-798-8559
Fax Number	:	561-798-8645

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

Provider Enumeration Date	:	11/21/2005
Last Update Date	:	07/25/2025

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Directions to “ MARIANA DOVAL M.D.” Practice Location

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