Individual
AMELIA THERESA WACK FIASTRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1 SHIRCLIFF WAY, JACKSONVILLE, FL 32204-4748
(999) 999-9999
Mailing address
1525 W CYPRESS CREEK RD, FT. LAUDERDALE, FL 33309
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME133225
FL
Other
Enumeration date
03/28/2011
Last updated
12/11/2025
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