Organization
FAVREAU DERMATOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MO TOLEDO (AUTHORIZED OFFICIAL)
(954) 457-4201
Entity
Organization
Contact information
Practice address
201 SE 14TH ST, FORT LAUDERDALE, FL 33316-1827
(954) 457-4201
Mailing address
201 SE 14TH ST, FORT LAUDERDALE, FL 33316-1827
(954) 457-4201
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
OS9004
FL
Other
Enumeration date
05/11/2017
Last updated
05/11/2017
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