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Individual

HEATHER ANN FAGAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
13535 NEMOURS PKWY, ORLANDO, FL 32827-7402
(407) 650-7000
(407) 567-5924
Mailing address
PO BOX 191, ROCKLAND, DE 19732-0191
(302) 651-6212
(602) 651-4945

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
036107219
IL
2080P0203X
Pediatric Critical Care Medicine Physician
036107219
IL
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
ME120308
FL

Other

Enumeration date
05/16/2006
Last updated
09/03/2014
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