Provider Demographics
NPI:1780725929
Name:DOROTHY V STRAW
Entity type:Organization
Organization Name:DOROTHY V STRAW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:VIOLA
Authorized Official - Last Name:STRAW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-584-8222
Mailing Address - Street 1:4100 NW 3RD CT
Mailing Address - Street 2:SUITE 110
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2813
Mailing Address - Country:US
Mailing Address - Phone:954-584-8222
Mailing Address - Fax:
Practice Address - Street 1:4100 NW 3RD CT
Practice Address - Street 2:SUITE 110
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2813
Practice Address - Country:US
Practice Address - Phone:954-584-8222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL263486400Medicaid