Individual
DR. ILYA FONAROV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
12955 SW 43RD CT, MIRAMAR, FL 33027-3182
(305) 829-1494
Mailing address
12955 SW 43RD CT, MIRAMAR, FL 33027-3182
(305) 829-1494
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
OS 9021
FL
208M00000X
Hospitalist Physician
Primary
OS9021
FL
Other
Enumeration date
08/10/2006
Last updated
06/14/2024
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