Healthcare Provider Details

I. General information

NPI: 1437568847
Provider Name (Legal Business Name): HUA E. FANG-PATRICK MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2014
Last Update Date: 08/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1951 SW 172ND AVE STE 410
MIRAMAR FL
33029-5614
US

IV. Provider business mailing address

1951 SW 172ND AVE STE 410
MIRAMAR FL
33029-5614
US

V. Phone/Fax

Practice location:
  • Phone: 954-499-0572
  • Fax: 954-499-3523
Mailing address:
  • Phone: 954-499-0572
  • Fax: 954-499-3523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: HUA E FANG-PATRICK
Title or Position: PEDIATRICIAN
Credential: MD
Phone: 954-499-0572