Provider Demographics
NPI:1225077019
Name:WALTER F PROANO, INC.
Entity Type:Organization
Organization Name:WALTER F PROANO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:
Authorized Official - Last Name:PROANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-392-9993
Mailing Address - Street 1:777 E 25TH ST
Mailing Address - Street 2:SUITE 419
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-3825
Mailing Address - Country:US
Mailing Address - Phone:305-693-5171
Mailing Address - Fax:305-693-5172
Practice Address - Street 1:777 E 25TH ST
Practice Address - Street 2:SUITE 419
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-3825
Practice Address - Country:US
Practice Address - Phone:305-693-5171
Practice Address - Fax:305-693-5172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty