Individual provider · Type 1 NPI
Michael Vincent Defazio, MD
Plastic and Reconstructive Surgery Physician · Jacksonville, FL
NPI number
1821354325
Active
Practice location
14546 Old Saint Augustine Rd Ste 407
Jacksonville, FL 32258-5473
Fax (904) 262-3306
Mailing address
11945 San Jose Blvd Ste 300
Jacksonville, FL 32223-1627
Other practice locations
- 3800 Reservoir Rd NW, Dept Of Plastic Surgery, Washington, DC 20007-2113 · (202) 444-1233
- 1400 Pressler St Unit 1488, Houston, TX 77030 · (713) 794-1247
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Plastic and Reconstructive Surgery Physician Primary | 2086S0122X | R6770 (TX) |
Plastic and Reconstructive Surgery Physician: A surgeon who specializes in plastic and reconstructive surgery.
2 other providers at this address
Other plastic and reconstructive surgery physician providers in Jacksonville
- Timothy Edward Fee, MDPlastic and Reconstructive Surgery Physician Jacksonville, FL NPI 1003876251
- John Murray, MDPlastic and Reconstructive Surgery Physician Jacksonville, FL NPI 1104869510
- Joachim W. Granzow, MDPlastic and Reconstructive Surgery Physician Jacksonville, FL NPI 1538178017
- David N. Csikai, MDPlastic and Reconstructive Surgery Physician Jacksonville, FL NPI 1639164692
- Vaishali B. Doolabh, MDPlastic and Reconstructive Surgery Physician Jacksonville, FL NPI 1649265463
- David Winton Mobley, MDPlastic and Reconstructive Surgery Physician Jacksonville, FL NPI 1861495723
- Ankit R. Desai, MDPlastic and Reconstructive Surgery Physician Jacksonville, FL NPI 1932302387
About NPI 1821354325
Michael Vincent Defazio, MD's National Provider Identifier is 1821354325, issued on Apr 9, 2012. The primary taxonomy on file is Plastic and Reconstructive Surgery Physician (2086S0122X), and the practice location is in Jacksonville, FL. The record was last updated on Aug 1, 2019.