Fana Medical Group, Tampa Rd LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME80639 Issued in FL

Legal business name

FANA MEDICAL GROUP, TAMPA RD LLC

Practice address

2626 Tampa Road, Suite 202
Palm Harbor, FL 34684

Phone

(727) 781-5811

Fax

(727) 781-5613

NPI assigned

Oct 19, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Miguel Antonio Fana Jr., MDNPI 1417926833

Title

Medical Director / Owner

Phone

(727) 781-5811

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Miguel Antonio Fana Jr., M.D.

  • Internal Medicine Physician
  • St Petersburg, FL
  • NPI 1417926833
  NPD Authorized official

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

{
    "created_epoch": "1350604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350604800000",
    "number": "1265785869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2626 TAMPA ROAD, SUITE #202",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "34684",
            "telephone_number": "727-781-5811",
            "fax_number": "727-781-5613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2626 TAMPA ROAD, SUITE 202",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "34684",
            "telephone_number": "727-781-5811",
            "fax_number": "727-781-5613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FANA MEDICAL GROUP, TAMPA RD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-19",
        "last_updated": "2012-10-19",
        "status": "A",
        "authorized_official_last_name": "FANA",
        "authorized_official_first_name": "MIGUEL",
        "authorized_official_middle_name": "ANTONIO",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR / OWNER",
        "authorized_official_telephone_number": "727-781-5811",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME80639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "259988100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Faiella, PTA
• Joshua Falleur
• Family Dental Group of Florida, PLLC
• Family Foot and Ankle Solutions Inc
• Family Psychological Services of Palm Harbor Inc
• Fanourios I. Ferderigos, M.D., P.a.
• Michael Farris, DCN, MS, LDN, CNS
• Dean A Fauber, M.D.
• Antonio Federico
• Nicole Renee Felton, DPT

• Internal Medicine Physician in Palm Harbor, FL
• Providers in Palm Harbor, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2012; 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.