Brian G. Fabian MD PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

M75652 Issued in FL

Legal business name

BRIAN G. FABIAN MD PA

Practice address

26800 S Tamiami TRL
#310
Bonita Springs, FL 34134-4349

Phone

(239) 949-0742

Fax

(239) 949-0768

NPI assigned

Dec 3, 2013

Organization subpart

No

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

Authorized official

Name

Mrs. Lucy Fabian, RN

Title

Practice Manager

Phone

(239) 949-0742

Specialties & licenses 1

Addresses

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.

• Brian G. Fabian MD PA

  • MOHS-Micrographic Surgery Physician
  • Bonita Springs, FL
  • NPI 1093983884
  NPD tax ID

Practitioners 1

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

• Brian George Fabian, MD

  • Dermatology Physician
  • Jacksonville, FL
  • NPI 1245362763
  NPD (past)

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

{
    "created_epoch": "1386028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386028800000",
    "number": "1578994372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26800 S TAMIAMI TRL",
            "address_2": "#310",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341344349",
            "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",
            "address_2": "#310",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341344349",
            "telephone_number": "239-949-0742",
            "fax_number": "239-949-0768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN G. FABIAN MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-03",
        "last_updated": "2013-12-03",
        "status": "A",
        "authorized_official_last_name": "FABIAN",
        "authorized_official_first_name": "LUCY",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "239-949-0742",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "M75652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brain and Spine Consultants, Inc.
• Brain Function Clinic
• Connie Brazelton
• William Breakstone
• Brian G. Fabian MD PA
• Joshua Gordon Bridge, DPT
• Kevin A Brintnell, BCBA
• Mark David Bronner, DMD
• Erin Lynn Brouillard, PA-C
• William F Brown, P.T.C.

• Specialist in Bonita Springs, FL
• Providers in Bonita Springs, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.