Individual
EDUARDO FANILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6963 SW 117TH AVE, MIAMI, FL 33183-2803
(786) 595-3225
(786) 595-7812
Mailing address
12301 SW 124TH CT, MIAMI, FL 33186-5476
(786) 573-3152
(786) 573-3152
Taxonomy
Speciality
Code
Description
License number
State
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
ME82787
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
262088000
—
FL
Enumeration date
06/19/2006
Last updated
07/17/2024
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