Provider Demographics
NPI:1144676651
Name:LALLA, FIORE ROBERT (MD)
Entity type:Individual
Prefix:MR
First Name:FIORE
Middle Name:ROBERT
Last Name:LALLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1106-600 THREE ISLAND BOULEVARD
Mailing Address - Street 2:APT 1106
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009
Mailing Address - Country:US
Mailing Address - Phone:514-426-8547
Mailing Address - Fax:514-505-1446
Practice Address - Street 1:4 CHABLIS STREET
Practice Address - Street 2:OFFICE 4212
Practice Address - City:KIRLAND
Practice Address - State:P.Q. (QUEBEC)
Practice Address - Zip Code:H9H5A6
Practice Address - Country:CA
Practice Address - Phone:514-418-1787
Practice Address - Fax:514-505-1446
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-13
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT035361208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice