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General NPI Number Information
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NPI Number | 1487150298
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Entity Type | Individual
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Provider Name | NICOLE MENDEZ FAUGHT MD
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Gender | Female
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Dates
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Enumeration Date | 04/02/2018
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 1131 N 35TH AVE STE 300
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City | HOLLYWOOD
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State | FL
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Zip | 33021-5403
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Country | US
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Telephone | 954-265-4475
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Fax | 954-276-0754
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Provider Business Mailing Address
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Address Line | 2900 CORPORATE WAY DOOR D
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City | MIRAMAR
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State | FL
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Zip | 33025-3925
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Country | US
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Telephone | 954-276-5603
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Fax | 954-985-7074
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME170407
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number | ME170407
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | ME170407
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License Number State | FL
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