Healthcare Provider Details

I. General information

NPI: 1730004896
Provider Name (Legal Business Name): DEBRA JEAN FAUST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5252 S TAMIAMI TRL STE 16
SARASOTA FL
34231-4260
US

IV. Provider business mailing address

5252 S TAMIAMI TRL
SARASOTA FL
34231-4260
US

V. Phone/Fax

Practice location:
  • Phone: 801-440-5592
  • Fax:
Mailing address:
  • Phone: 801-440-5592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT12430
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: