Organization
FANA MEDICAL GROUP PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIGUEL ANTONIO FANA M.D. (MEDICAL DIRECTOR & OWNER)
(727) 384-0192
Entity
Organization
Contact information
Practice address
5798 38TH AVENUE NORTH, SAINT PETERSBURG, FL 33710-1926
(727) 384-0192
(727) 384-1500
Mailing address
5798 38TH AVENUE NORTH, SAINT PETERSBURG, FL 33710-1926
(727) 384-0192
(727) 384-1500
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME80639
FL
Other
Enumeration date
03/16/2006
Last updated
07/26/2013
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