Provider Demographics
NPI:1316906340
Name:FACEY, SHERYL ROSEMARIE (MD)
Entity type:Individual
Prefix:MRS
First Name:SHERYL
Middle Name:ROSEMARIE
Last Name:FACEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1757 N UNIVERSITY DRIVE
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-3601
Mailing Address - Country:US
Mailing Address - Phone:954-981-6920
Mailing Address - Fax:
Practice Address - Street 1:1757 N UNIVERSITY DRIVE
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-3601
Practice Address - Country:US
Practice Address - Phone:954-981-6920
Practice Address - Fax:954-981-6922
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-20
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME85432207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL11634135OtherCAQH
FLME85432OtherLICENCE NUMBER
FL265340100Medicaid
FL265340100Medicaid
FLME85432OtherLICENCE NUMBER
FLBF7957890OtherDEA