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General NPI Number Information
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NPI Number | 1386635480
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Entity Type | Individual
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Provider Name | FAISAL A FAKIH MD
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Gender | Male
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Dates
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Enumeration Date | 10/31/2005
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Last Update Date | 12/10/2012
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Provider Practice Location Address
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Address Line | 1788 W FAIRBANKS AVE STE A
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City | WINTER PARK
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State | FL
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Zip | 32789
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Country | US
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Telephone | 407-740-5447
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Fax | 407-740-5532
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Provider Business Mailing Address
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Address Line | 1788 W FAIRBANKS AVE STE A
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City | WINTER PARK
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State | FL
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Zip | 32789
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Country | US
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Telephone | 407-740-5447
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Fax | 407-740-5532
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME0034351
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License Number State | FL
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