Individual
CHRISTOPHER CHARLES FANELLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3000 SW 148TH AVE STE 115, MIRAMAR, FL 33027-4181
(954) 438-7000
Mailing address
3000 SW 148TH AVE STE 115, MIRAMAR, FL 33027-4181
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
9115102
FL
Other
Enumeration date
09/13/2021
Last updated
10/28/2021
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