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Individual

VITALY JAIME ALALU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6944 LAKE WORTH RD, 2ND FLOOR, LAKE WORTH, FL 33467-2948
(561) 732-2900
(561) 740-9064
Mailing address
PO BOX 740177, BOYNTON BEACH, FL 33474-0177
(561) 740-2900
(561) 434-0598

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME29180
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
065172900
FL
Enumeration date
07/09/2006
Last updated
01/19/2017
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