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General NPI Number Information
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NPI Number | 1083776181
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Entity Type | Organization
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Legal Business Name | MARCO A FABREGA JR. MD PA
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8180 NW 36TH ST SUITE 310
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City | DORAL
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State | FL
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Zip | 33166-6645
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Country | US
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Telephone | 305-594-3038
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Fax |
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Provider Business Mailing Address
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Address Line | 4613 N UNIVERSITY DR 280
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City | CORAL SPRINGS
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State | FL
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Zip | 33067-4602
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARCO A FABREGA JR.
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Credential | M.D.
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Telephone | 954-303-2510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | ME82033
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License Number State | FL
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