Healthcare Provider Details

I. General information

NPI: 1326658899
Provider Name (Legal Business Name): FABIAN ALEXANDER TURUSHINA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2020
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18540 US HIGHWAY 441
MOUNT DORA FL
32757-6725
US

IV. Provider business mailing address

18540 US HIGHWAY 441
MOUNT DORA FL
32757-6725
US

V. Phone/Fax

Practice location:
  • Phone: 352-383-1667
  • Fax: 352-357-6045
Mailing address:
  • Phone: 352-383-1667
  • Fax: 352-357-6045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberACN1311
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: