Organization
FANA MEDICAL GROUP PORT RICHEY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIGUEL A FANA JR. M.D. (PRESIDENT)
(813) 382-7898
Entity
Organization
Contact information
Practice address
7505 ROTTINGHAM RD, PORT RICHEY, FL 34668-2648
(727) 849-2600
(727) 847-7703
Mailing address
5537 GULF DR, NEW PORT RICHEY, FL 34652-4021
(727) 849-2600
(727) 847-7703
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME80639
FL
Other
Enumeration date
01/29/2013
Last updated
01/29/2013
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