FAHED FAYAD MD PA
Radiology at 12 Ave, Miami, FL

License number
Florida ME55854
Category
Radiology
Type
Radiation Oncology
Owner
Name: FAHED FAYAD MD
Title: PRESIDENT
Phone: (305) 582-2068
Address
Address
1400 NW 12Th Ave, Miami, FL 33136
National Provider ID: 1558391433
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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FAHED FAYAD, M.D., PA

5601 Collins Ave SUITE 612, Miami Beach, FL 33140

Status:
Inactive
Inactive reason:
CANCEL ADM DISS/REV
Registration:
Sep 30, 1993
Inactive since:
Dec 8, 2005
State ID:
P93000069266
Business type:
Florida Profit Corporation
President, Treasurer, Secretary, Director:
Fahed Fayad (President, Treasurer, Secretary, Director), 5601 Collins Ave SUITE 612, Miami Beach, FL 33140 (Physical)
Agent:
Fayad, Fahed,5601 Collins Ave SUITE 612, Miami Beach, FL 33140 (Physical)
EIN:
750452266

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