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THERESA FORTALEZA-DAWSON MD PA NPI 1144426040


NPI Information

NPI: 1144426040
Provider Name: THERESA FORTALEZA-DAWSON MD PA

Doing Business As: INTERNAL MEDICINE & GERIATRIC HEALTH

Classification: Internal Medicine - 207RG0300X
Entity Type: Organization

Specialization: Geriatric Medicine

CLIA Number: 10D2107219

Address:
2006 NE 49TH ST
FT LAUDERDALE, FL
ZIP 33308
Phone: (954) 938-8998
Get Directions

THERESA FORTALEZA-DAWSON MD PA is a geriatric medicine internal medicine in Ft Lauderdale, FL. The provider is an internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. THERESA FORTALEZA-DAWSON MD PA NPI is 1144426040. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Internal Medicine & Geriatric Health.

The provider's business location address is:

2006 NE 49TH ST
FT LAUDERDALE, FL
ZIP 33308-524
Phone: (954) 938-8998
Fax: (954) 938-8984

The provider's authorized official is Theresa Fortaleza-dawson .
The authorized official title is Owner and has the following contact phone number (954) 938-8998.

The CLIA number assigned to this NPI record is 10D2107219 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/26/2007 and was last updated on 1/24/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RG0300XInternal MedicineGeriatric MedicineME81298FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1280599OTHERFLORIDAAVMED
250293OTHERFLORIDANEIGHBORHOOD HEALTH
3268019000MEDICAIDFLORIDA
4K5066MEDICARE PINFLORIDA
503018OTHERFLORIDABLUE CROSS BLUE SHIELD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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