Provider Demographics
NPI:1720052087
Name:FAKIOGLU, HARUN (MD)
Entity Type:Individual
Prefix:MR
First Name:HARUN
Middle Name:
Last Name:FAKIOGLU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 W MILLER ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-2032
Mailing Address - Country:US
Mailing Address - Phone:407-649-6944
Mailing Address - Fax:321-843-3210
Practice Address - Street 1:92 W MILLER ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-2032
Practice Address - Country:US
Practice Address - Phone:407-649-6944
Practice Address - Fax:321-841-4260
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME779662080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL270511700Medicaid
FLME77966OtherMEDICAL LICENSE
FLCW278WMedicare PIN