Individual
HENRIETE D FAILLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2627 NE 203RD ST STE 101, AVENTURA, FL 33180-1945
(305) 935-2452
Mailing address
1000 BELLE MEADE ISLAND DR, MIAMI, FL 33138-5252
(305) 935-2452
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ME0064004
FL
Other
Enumeration date
04/16/2008
Last updated
04/16/2008
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