Individual
BRIAN JOHN FAZZONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1515 SW ARCHER RD, GAINESVILLE, FL 32608-1134
(352) 265-0916
Mailing address
1515 SW ARCHER RD, GAINESVILLE, FL 32608-1134
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/15/2018
Last updated
05/15/2018
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