Organization
JACK FAUP MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACK FAUP M.D. (MEDICAL DOCTOR)
(407) 299-3160
Entity
Organization
Contact information
Practice address
1515 PARK CENTER DR, SUITE 2-I, ORLANDO, FL 32835-5794
(407) 299-3160
(407) 299-2445
Mailing address
1515 PARK CENTER DR, SUITE 2-I, ORLANDO, FL 32835-5794
(407) 299-3160
(407) 299-2445
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME15851
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
048731700
—
FL
Enumeration date
09/20/2006
Last updated
10/14/2008
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