Basic Information
| Provider Information | |||||||||
| NPI: | 1801869987 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RAILEY | ||||||||
| FirstName: | DEAN | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5431 N UNIVERSITY DR | ||||||||
| Address2: | |||||||||
| City: | CORAL SPRINGS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330674639 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9543442522 | ||||||||
| FaxNumber: | 9543449189 | ||||||||
| Practice Location | |||||||||
| Address1: | 8329 W SUNRISE BLVD | ||||||||
| Address2: | |||||||||
| City: | PLANTATION | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333225405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9546271617 | ||||||||
| FaxNumber: | 8662245691 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/09/2006 | ||||||||
| LastUpdateDate: | 04/16/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | ME0048884 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | 207R00000X | ME0048884 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 07097V | 01 | FL | MEDICARE PROVIDER # | OTHER | 048292700 | 05 | FL | MEDICAID | D51854 | 01 | FL | UPIN | OTHER |