JOSEPH FANFAN JR MD PA
NPI 1689059453
Clinic/Center in Wilton Manors, FL

Q: What is La Clinique 300 Inc's NPI number?

The NPI number for La Clinique 300 Inc is 1689059453. It was assigned to this organization in the NPPES registry on July 22, 2015. The provider is doing business as Joseph Fanfan Jr MD PA.

Q: What is La Clinique 300 Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Active since July 22, 2015

2630 N ANDREWS AVE, WILTON MANORS, FL 33311(954) 525-4900(954) 396-3110 Get Directions Write a Review

NPPES record last updated: May 9, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 9, 2016, Feb 11, 2016 (2 updates tracked since 2016).

On this page

About Joseph Fanfan Jr Md Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JOSEPH FANFAN JR MD PA (NPI 1689059453) is a healthcare organization registered as a clinic/center in Wilton Manors, Florida and active in the NPI registry since July 2015. The organization lists Joseph Fanfan, President, as its authorized official.

NPPES Registry Identity

NPI1689059453

Entity TypeOrganization

Primary Taxonomy261Q00000X

Legal Business NameLA CLINIQUE 300 INC

Location Address2630 N ANDREWS AVEWilton Manors, FL 33311-2550

Mailing Address2630 N Andrews AveWilton Manors, FL 33311-2550 · (954) 525-4900 · Fax (954) 396-3110

Phone(954) 525-4900

Fax(954) 396-3110

Organization SubpartYesParent: Joseph Fanfan Jr Md Pa

Authorized OfficialJoseph FanfanPresident · (954) 525-4900

Enumeration DateJuly 22, 2015

Last NPPES UpdateMay 9, 20162 updates tracked since enumeration

✔ NPI 1689059453 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities

Taxonomy Code261Q00000X

License✔ Licensed in FL · ME43065

Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

2630 N ANDREWS AVE, Wilton Manors, FL 33311

Open in Google Maps ↗

Other Names 1

Doing Business AsJoseph Fanfan Jr Md Pa

Other Identifiers 3

Medicaid068166100FL

Medicare PIN94236FL

Medicare UPIND63170FL

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LISETTE PLANCHER NP-C-PA

Nurse Practitioner

2630 N ANDREWS AVE
WILTON MANORS, FL 33311

Broward County (954) 525-4900

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is La Clinique 300 Inc's NPI number?

The NPI number for La Clinique 300 Inc is 1689059453. It was assigned to this organization in the NPPES registry on July 22, 2015. The provider is doing business as Joseph Fanfan Jr MD PA.

Where is La Clinique 300 Inc located?

La Clinique 300 Inc is located at 2630 N Andrews Ave, Wilton Manors, FL 33311. The listed phone number is (954) 525-4900.

What is La Clinique 300 Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

When was this NPI record last updated?

The NPPES record for La Clinique 300 Inc was last updated on May 9, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.