Individual
BRENDA GERALDINE FAHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 273-8610
(352) 273-8612
Mailing address
PO BOX 918025, ORLANDO, FL 32891-8025
(352) 273-8610
(352) 273-8612
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
37397
KY
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
37397
KY
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
Primary
ME111288
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004299900
—
FL
Enumeration date
08/22/2006
Last updated
01/03/2012
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