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Individual

ALI FATHOLLAHI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3650 NW 82ND AVE STE PH501, DORAL, FL 33166-6658
(305) 251-8650
(305) 251-8913
Mailing address
3650 NW 82ND AVE STE PH501, DORAL, FL 33166-6658
(305) 251-8650
(305) 251-8913

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME177767
FL
390200000X
Student in an Organized Health Care Education/Training Program
Primary
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
113895800
FL
Enumeration date
06/03/2015
Last updated
04/15/2026
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