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General NPI Number Information
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NPI Number | 1306652995
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Entity Type | Organization
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Legal Business Name | FIRST PATIENT CARE CLINIC @ DAVIE
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Dates
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Enumeration Date | 12/09/2024
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 3228 DAVIE BLVD
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City | FORT LAUDERDALE
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State | FL
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Zip | 33312-2766
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Country | US
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Telephone | 954-533-4508
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Fax | 561-266-3447
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Provider Business Mailing Address
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Address Line | 3228 DAVIE BLVD
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City | FORT LAUDERDALE
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State | FL
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Zip | 33312-2766
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Country | US
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Telephone | 954-533-4508
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | GUERRY FAUSTIN
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Credential |
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Telephone | 561-266-3487
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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