Provider Demographics
NPI:1972500585
Name:DALILI, CURTIS (MD)
Entity Type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:
Last Name:DALILI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 37TH PL
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-4502
Mailing Address - Country:US
Mailing Address - Phone:772-794-2222
Mailing Address - Fax:772-794-0045
Practice Address - Street 1:1715 37TH PL
Practice Address - Street 2:2ND FLOOR
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-4502
Practice Address - Country:US
Practice Address - Phone:772-794-2222
Practice Address - Fax:772-794-0045
Is Sole Proprietor?:No
Enumeration Date:2005-06-29
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0069421207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL38216OtherBCBS
FL38216Medicare ID - Type UnspecifiedMEDICARE