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Mr. Avichai Fagan
Student in an Organized Health Care Education/Training Program in Fort Lauderdale, Florida
NPI 1356084487

Avichai Fagan is a Student in an Organized Health Care Education/Training Program based in Baltimore, FL. Avichai Fagan practices in Fort Lauderdale, FL. The NPI Number for Avichai Fagan is 1356084487 and holds a License No. (Florida).

The current practice location address for Avichai Fagan is 1600 S Andrews Ave, Fort Lauderdale, FL and can be reached out via phone at 786-910-3801.

Location: 1600 S Andrews Ave, Fort Lauderdale, FL, 21208-2285
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1356084487
Provider Name
Avichai Fagan
Credential
Provider Entity Type
Individual
Gender
Male
Address
1600 S Andrews Ave, Fort Lauderdale, FL, 21208-2285
Phone Number
786-910-3801
Fax Number
Provider Enumeration Date
04/17/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1600 S Andrews Ave
City
Fort Lauderdale
State
Florida
Zip
33316-2510
Phone Number
786-910-3801
Fax Number
person
Provider Business Mailing Address Details
Address
1600 S Andrews Ave
City
Fort Lauderdale
State
Florida
Zip
33316-2510
Phone Number
786-910-3801
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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