Fasano, John Bradford

Fasano, John Bradford is an sole proprietor health care provider with primary practice located at 509 Se Riverside Dr Suite 206, Stuart FL 34994-2579. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery, which is considered as his primary health care specialty. Fasano, John Bradford can be contacted via phone (772) 221-9111.

Contact Information

Primary practice address
509 Se Riverside Dr Suite 206 Stuart FL 34994-2579
Phone: (772) 221-9111
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X 61260 Florida

Profile Details

NPI number 1649281346
LBN Legal business name Fasano, John Bradford
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 10th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649281346 NPPES
Florida MEDICAID 374249100

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