Fana Medical Group Port Richey LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME80639 Issued in FL

Legal business name

FANA MEDICAL GROUP PORT RICHEY LLC

Practice address

7505 Rottingham Rd
Port Richey, FL 34668-2648

Phone

(727) 849-2600

Fax

(727) 847-7703

NPI assigned

Jan 29, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Miguel A Fana Jr., M.D.

Title

President

Phone

(813) 382-7898

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1359417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359417600000",
    "number": "1356689111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5537 GULF DR",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346524021",
            "telephone_number": "727-849-2600",
            "fax_number": "727-847-7703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7505 ROTTINGHAM RD",
            "city": "PORT RICHEY",
            "state": "FL",
            "postal_code": "346682648",
            "telephone_number": "727-849-2600",
            "fax_number": "727-847-7703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FANA MEDICAL GROUP PORT RICHEY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-29",
        "last_updated": "2013-01-29",
        "status": "A",
        "authorized_official_last_name": "FANA",
        "authorized_official_first_name": "MIGUEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-382-7898",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME80639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Port Richey, FL
• Providers in Port Richey, 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 Jan 29, 2013; 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.