Provider Demographics
NPI:1992712913
Name:LLORET FIALKOW & GOMEZ MDS PA
Entity type:Organization
Organization Name:LLORET FIALKOW & GOMEZ MDS PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:LLORET
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-275-8200
Mailing Address - Street 1:7400 SW 87TH AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173
Mailing Address - Country:US
Mailing Address - Phone:305-275-8200
Mailing Address - Fax:305-274-7812
Practice Address - Street 1:7400 SW 87TH AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173
Practice Address - Country:US
Practice Address - Phone:305-275-8200
Practice Address - Fax:305-274-7812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL33076Medicare ID - Type Unspecified