NPIMap

Organization Active NPI

Brian G. Fabian MD PA

  • MOHS-Micrographic Surgery Physician
  • Bonita Springs, FL
National Provider Identifier
1093983884
Registry record updated Feb 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
ME75652 Issued in FL
Legal business name
BRIAN G. FABIAN MD PA
Practice address
26800 S Tamiami TRL Ste 310
Bonita Springs, FL 34134-4348
Phone
(239) 949-0742
Fax
(239) 949-0768
NPI assigned
Feb 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Brian George Fabian, MDNPI 1245362763
Title
President
Phone
(239) 949-0742

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ND0101X ME75652 FL Primary

Addresses

Primary practice location

26800 S Tamiami TRL Ste 310
Bonita Springs, FL 34134-4348

Mailing address

26800 S Tamiami TRL Ste 310
Bonita Springs, FL 34134-4348
Phone (239) 949-0742

National Provider Directory

National Provider Directory
Tax ID family
Brian G Fabian MD PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

26800 S Tamiami Trl
Ste 310
Bonita Springs, FL 34134
Phone (239) 949-0742

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1202947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202947200000",
    "number": "1093983884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26800 S TAMIAMI TRL STE 310",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341344348",
            "telephone_number": "239-949-0742",
            "fax_number": "239-949-0768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26800 S TAMIAMI TRL STE 310",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341344348",
            "telephone_number": "239-949-0742",
            "fax_number": "239-949-0768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN G. FABIAN MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-14",
        "last_updated": "2008-02-14",
        "status": "A",
        "authorized_official_last_name": "FABIAN",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-949-0742",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "FL",
            "license": "ME75652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonita Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.