Individual
MR. AVICHAI FAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1600 S ANDREWS AVE, FORT LAUDERDALE, FL 33316-2510
(786) 910-3801
Mailing address
8506 REBECCA LAUREN CT, BALTIMORE, MD 21208-2285
(443) 630-6971
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
OS22367
FL
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/17/2022
Last updated
12/22/2025
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