Individual
YAO-SHAN FAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000
Mailing address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
MFC1592
FL
207ZC0006X
Clinical Pathology Physician
ME133010
FL
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
ME133010
FL
Other
Enumeration date
05/11/2006
Last updated
11/24/2020
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