Provider Demographics
NPI:1700873734
Name:FALABELLA, ANNA (MD)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:FALABELLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3850 HOLLYWOOD BLVD
Mailing Address - Street 2:STE 301
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-6748
Mailing Address - Country:US
Mailing Address - Phone:954-961-1200
Mailing Address - Fax:954-963-0378
Practice Address - Street 1:3000 SW 148TH AVE
Practice Address - Street 2:STE 250
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-4169
Practice Address - Country:US
Practice Address - Phone:954-885-5551
Practice Address - Fax:954-885-5559
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-04
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME75028207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL43386Medicare ID - Type Unspecified
G68108Medicare UPIN