Basic Information
Provider Information
NPI: 1467026229
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ANIOL
FirstName: CLAUDIA
MiddleName: VERONICA
NamePrefix:  
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1600 S ANDREWS AVE
Address2:  
City: FORT LAUDERDALE
State: FL
PostalCode: 333162510
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 1600 S ANDREWS AVE
Address2:  
City: FORT LAUDERDALE
State: FL
PostalCode: 333162510
CountryCode: US
TelephoneNumber: 9543554400
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/17/2021
LastUpdateDate: 05/17/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/17/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X FLY Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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