Provider Demographics
NPI:1417106188
Name:BUFFALLINO, JOSEPH P (DO)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:P
Last Name:BUFFALLINO
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 1:400 LESLIE DR
Mailing Address - Street 2:PH-1110
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-2914
Mailing Address - Country:US
Mailing Address - Phone:305-965-3839
Mailing Address - Fax:
Practice Address - Street 1:400 LESLIE DR
Practice Address - Street 2:PH-1110
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-2914
Practice Address - Country:US
Practice Address - Phone:305-965-3839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS3610208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine