Healthcare Provider Details

I. General information

NPI: 1770625568
Provider Name (Legal Business Name): JOZSEF FABIAN MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 01/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 PASADENA AVE S
SOUTH PASADENA FL
33707-3717
US

IV. Provider business mailing address

2680 HUNT RD
TARPON SPRINGS FL
34688-7335
US

V. Phone/Fax

Practice location:
  • Phone: 727-938-8806
  • Fax: 727-934-6370
Mailing address:
  • Phone: 727-938-8806
  • Fax: 727-934-6370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME76613
License Number StateFL

VIII. Authorized Official

Name: DR. JOZSEF FABIAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 727-938-8806