Organization
DORILAS FOUNDATION CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FANUEL DORILAS MD (PHYSICIAN)
(954) 478-2041
Entity
Organization
Contact information
Practice address
3510 NW 8TH ST, FORT LAUDERDALE, FL 33311-6416
(954) 478-2041
Mailing address
3510 NW 8TH ST, FORT LAUDERDALE, FL 33311-6416
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
70734
GA
Other
Enumeration date
03/03/2015
Last updated
03/03/2015
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