Individual
LAUREN FAYE FANTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, MPH
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-4402
(352) 273-5550
Mailing address
PO BOX 100236, GAINESVILLE, FL 32610-0236
(352) 273-5550
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
ME149503
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/04/2017
Last updated
10/24/2022
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