Individual provider · Type 1 NPI

Avichai Fagan

Student in an Organized Health Care Education/Training Program · Fort Lauderdale, FL

NPI number 1356084487 Active

Practice location

1600 S Andrews Ave
Fort Lauderdale, FL 33316-2510

Call (786) 910-3801 Map

Mailing address

8506 Rebecca Lauren Ct
Baltimore, MD 21208-2285

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed
Emergency Medicine Physician 207P00000XOS22367 (FL)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1356084487

Avichai Fagan's National Provider Identifier is 1356084487, issued on Apr 17, 2022. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Fort Lauderdale, FL. The record was last updated on Dec 22, 2025.