Individual
MARIE FAZZARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
101 RIVERFRONT BLVD STE 700, BRADENTON, FL 34205-8823
(941) 748-2417
(941) 748-3694
Mailing address
101 RIVERFRONT BLVD STE 700, BRADENTON, FL 34205-8823
(941) 748-2417
(941) 748-3694
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME0064513
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110078702
RAILROAD MEDICARE
—
01
—
23540
BLUECROSS BLUE SHIELD
FL
01
—
29-05295
UNITED HEALTH CARE
—
01
—
5339083
AETNA PPO
—
01
—
6956161004
CIGNA
—
01
—
968688
AETNA HMO
—
Enumeration date
10/17/2005
Last updated
10/08/2018
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