Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | ME136687 | FL |
N | 111NI0900X | Internist | ME136687 | FL |
N | 207RH0000X | Hematologist | ME136687 | FL |
N | 207RH0003X | Hematology & Oncology | 36224 | MT |
Y | 207RX0202X | Medical Oncology | ME136687 | FL |
NPI | 1467681833 |
---|---|
Provider Name | Jesus Carlos Fabregas Mercado |
First Address | Gainesville, FL 32610-0278 |
Second Address | Billings, MT 59101-0905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2009 |
Last Update Date | 31/08/2021 |