MEDICARE: DR. HUA FANG-PATRICK MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080P0204X	Pediatric Emergency Medicine (Pediatrics) Physician	ME73730	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215926415
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HUA FANG-PATRICK MD

Provider Business Mailing Address
First Line	:	1951 SW 172ND AVE
Second Line	:	STE 410
City	:	MIRAMAR
State	:	FL
Zip	:	33029-5593
Country	:	US
Telephone Number	:	954-499-0572
Fax Number	:

Provider Business Practice Location Address
First Line	:	1951 SW 172ND AVE
Second Line	:	STE 410
City	:	MIRAMAR
State	:	FL
Zip	:	33029-5593
Country	:	US
Telephone Number	:	954-499-0572
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2005
Last Update Date	:	05/31/2013

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