Provider Demographics
NPI:1376299545
Name:FALCON, VICTOR MANUEL
Entity Type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:MANUEL
Last Name:FALCON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5995 SW 113TH ST
Mailing Address - Street 2:
Mailing Address - City:PINECREST
Mailing Address - State:FL
Mailing Address - Zip Code:33156-5024
Mailing Address - Country:US
Mailing Address - Phone:954-243-0453
Mailing Address - Fax:
Practice Address - Street 1:5995 SW 113TH ST
Practice Address - Street 2:
Practice Address - City:PINECREST
Practice Address - State:FL
Practice Address - Zip Code:33156-5024
Practice Address - Country:US
Practice Address - Phone:954-243-0453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-26
Last Update Date:2022-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program