Provider Demographics
NPI:1346851797
Name:FARAG, SUZY SAMEH (MD)
Entity type:Individual
Prefix:DR
First Name:SUZY
Middle Name:SAMEH
Last Name:FARAG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SUZY
Other - Middle Name:SAMEH
Other - Last Name:GUIRGUIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1325 TOMOKA TOWN CENTER DRIVE
Mailing Address - Street 2:APT 404
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32117
Mailing Address - Country:US
Mailing Address - Phone:561-563-3331
Mailing Address - Fax:203-573-6707
Practice Address - Street 1:1776 N. WILLIAMSON BLVD.
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32117
Practice Address - Country:US
Practice Address - Phone:386-323-7500
Practice Address - Fax:203-573-7031
Is Sole Proprietor?:No
Enumeration Date:2020-08-10
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL164827207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine