Healthcare Provider Details

I. General information

NPI: 1508468281
Provider Name (Legal Business Name): STEVEN FAGIEN MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2020
Last Update Date: 11/09/2020
Certification Date: 11/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 GLADES RD STE 210
BOCA RATON FL
33431-6466
US

IV. Provider business mailing address

660 GLADES RD STE 210
BOCA RATON FL
33431-6466
US

V. Phone/Fax

Practice location:
  • Phone: 561-393-9898
  • Fax:
Mailing address:
  • Phone: 561-393-9898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: STEVEN FAGIEN
Title or Position: MD, OWNER
Credential: MD
Phone: 561-393-9898