Provider Demographics
NPI:1306652995
Name:FIRST PATIENT CARE CLINIC @ DAVIE
Entity type:Organization
Organization Name:FIRST PATIENT CARE CLINIC @ DAVIE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GUERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:FAUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-266-3487
Mailing Address - Street 1:3228 DAVIE BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-2766
Mailing Address - Country:US
Mailing Address - Phone:954-533-4508
Mailing Address - Fax:
Practice Address - Street 1:3228 DAVIE BLVD
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-2766
Practice Address - Country:US
Practice Address - Phone:954-533-4508
Practice Address - Fax:561-266-3447
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FIRST PATIENT CARE CLINIC,INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care