Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | ME 12886 | FL |
Y | 208600000X | Surgeon | ME 12886 | FL |
NPI | 1003974528 |
---|---|
Provider Name | Dr. Robert Keith Fabric |
First Address | Aventura, FL 33160-4923 |
Second Address | Aventura, FL 33160-4923 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2006 |
Last Update Date | 08/07/2007 |