Provider Demographics
NPI:1790926053
Name:FABEI MEDICAL GROUP
Entity Type:Organization
Organization Name:FABEI MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:FEIGIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-423-5268
Mailing Address - Street 1:12200 SAN SERVANDO AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH PORT
Mailing Address - State:FL
Mailing Address - Zip Code:34287-1229
Mailing Address - Country:US
Mailing Address - Phone:941-423-5268
Mailing Address - Fax:
Practice Address - Street 1:12200 SAN SERVANDO AVE
Practice Address - Street 2:
Practice Address - City:NORTH PORT
Practice Address - State:FL
Practice Address - Zip Code:34287-1229
Practice Address - Country:US
Practice Address - Phone:941-423-5268
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-17
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty