Provider Demographics
NPI:1154465268
Name:DORAL HEALTHCARE INC
Entity Type:Organization
Organization Name:DORAL HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILFREDO
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-470-9002
Mailing Address - Street 1:9851 NW 58TH ST
Mailing Address - Street 2:SUITE 109
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-2973
Mailing Address - Country:US
Mailing Address - Phone:305-470-9002
Mailing Address - Fax:305-470-9934
Practice Address - Street 1:9851 NW 58TH ST
Practice Address - Street 2:SUITE 109
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-2973
Practice Address - Country:US
Practice Address - Phone:305-470-9002
Practice Address - Fax:305-470-9934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2009-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty