M W Formisano MD PA

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

ME91614 Issued in FL

Legal business name

M W FORMISANO MD PA

Practice address

4024 N Circle Dr
Hollywood, FL 33021-6726

Phone

(954) 989-4110

Fax

(954) 989-7855

NPI assigned

Jun 8, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Michael William Formisano, M,D,

Title

President

Phone

(954) 989-4110

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1244419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244419200000",
    "number": "1730315490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4024 N CIRCLE DR",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216726",
            "telephone_number": "954-989-4110",
            "fax_number": "954-989-7855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4024 N CIRCLE DR",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216726",
            "telephone_number": "954-989-4110",
            "fax_number": "954-989-7855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M W FORMISANO MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-08",
        "last_updated": "2009-06-08",
        "status": "A",
        "authorized_official_last_name": "FORMISANO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-989-4110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M,D,"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME91614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Lynn
• Roni Lynn, O.T. L
• James C Lyons, DDS
• Violetta Lyra, M.D.
• Orville Lyttle, BCBA
• M.B.M Medical Supply, Inc
• M&S Compassionate Care LLC
• Tiffany Marie Mabin, OTR/L
• Thomas Henry Macaluso, M.D.
• Heydi Lianet Machado Benavides, RBT

• General Practice Physician in Hollywood, FL
• Providers in Hollywood, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.