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Individual

ROGERIO S. FAILLACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1951 SW 172 AVE, SUITE 304, MIRAMAR, FL 33029
(954) 441-1144
(954) 441-4404
Mailing address
1951 SW 172 AVENUE, SUITE 304, MIRAMAR, FL 33029
(954) 441-1144
(954) 441-4404

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME 77924
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
259184700
FL
Enumeration date
11/13/2006
Last updated
07/08/2007
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