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General NPI Number Information
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NPI Number | 1003798786
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Entity Type | Organization
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Legal Business Name | NATASHA A FAJARDO MD PA
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Dates
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Enumeration Date | 07/23/2025
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 5995 SW 71ST ST STE 403-A
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-3531
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Country | US
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Telephone | 305-894-7400
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Fax | 305-894-7487
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Provider Business Mailing Address
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Address Line | 12555 SW 46TH ST
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City | MIAMI
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State | FL
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Zip | 33175-4725
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Country | US
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Telephone | 786-338-5020
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Fax | 305-894-7400
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. NATASHA AILIME FAJARDO
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Credential | MD
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Telephone | 786-338-5020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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