Individual
ALFREDO FANELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1770 N WICKHAM RD, MELBOURNE, FL 32935-8122
(321) 235-0606
Mailing address
1770 N WICKHAM RD, MELBOURNE, FL 32935-8122
(321) 235-9792
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DN12492
FL
Other
Enumeration date
12/11/2006
Last updated
07/08/2007
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