Provider Demographics
NPI:1316906340
Name:FACEY, SHERYL R (MD)
Entity type:Individual
Prefix:
First Name:SHERYL
Middle Name:R
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 1:11645 BISCAYNE BLVD STE 207
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-3138
Mailing Address - Country:US
Mailing Address - Phone:305-538-8835
Mailing Address - Fax:305-994-0054
Practice Address - Street 1:11645 BISCAYNE BLVD STE 408
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-3148
Practice Address - Country:US
Practice Address - Phone:305-538-8835
Practice Address - Fax:305-994-0054
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME85432207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL265340100Medicaid
FLME85432OtherLICENCE NUMBER
FL265340100Medicaid
FL265340100Medicaid
FLME85432OtherLICENCE NUMBER
FLBF7957890OtherDEA