Provider Demographics
NPI:1154645430
Name:TOTFALUSI, VICTOR (DO)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:TOTFALUSI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18459 PINES BLVD
Mailing Address - Street 2:#213
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-1400
Mailing Address - Country:US
Mailing Address - Phone:954-990-0595
Mailing Address - Fax:954-990-0596
Practice Address - Street 1:8201 WEST BROWARD
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33324-2701
Practice Address - Country:US
Practice Address - Phone:954-990-0595
Practice Address - Fax:954-990-0596
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-16
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0S10987207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004412700Medicaid
FLE0485ZMedicare PIN