Provider Demographics
NPI:1669483665
Name:FINGADO, BRIAN H
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:H
Last Name:FINGADO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5597 N DIXIE HIGHWAY
Mailing Address - Street 2:ORTHOPAEDIC CENTER
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-4603
Mailing Address - Country:US
Mailing Address - Phone:954-958-4800
Mailing Address - Fax:954-958-4899
Practice Address - Street 1:5597 N DIXIE HIGHWAY
Practice Address - Street 2:ORTHOPAEDIC CENTER
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33334-4603
Practice Address - Country:US
Practice Address - Phone:954-958-4800
Practice Address - Fax:954-958-4899
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME78468207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL257270200Medicaid
FL257270200Medicaid
FLG84564Medicare UPIN