Organization
EUGENIO E FIALLOS MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EUGENIO E FIALLOS M.D. (PRESIDENT)
(305) 559-2173
Entity
Organization
Contact information
Practice address
12451 SW 21ST LN, MIAMI, FL 33175-7708
(305) 559-2173
Mailing address
12451 SW 21ST LN, MIAMI, FL 33175-7708
(305) 559-2173
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
ME36054
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1245379577
NPI TYPE 1
FL
Enumeration date
01/23/2012
Last updated
01/23/2012
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