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Individual

DR. IRA FIALKO

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
6171 W GULF TO LAKE HWY, CRYSTAL RIVER, FL 34429-2679
(352) 563-0220
(352) 563-0706
Mailing address
6171 W GULF TO LAKE HWY, CRYSTAL RIVER, FL 34429-2679
(352) 563-0220
(352) 563-0706

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
OS4404
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
100562
AVMED
FL
01
202840
WELLCARE HEALTHEASE
FL
01
82630
BCBS OF FLORIDA
FL
Enumeration date
05/04/2006
Last updated
07/09/2007
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