Provider Demographics
NPI:1043247844
Name:ALMEIDA, FAUSTO X (PA)
Entity Type:Individual
Prefix:
First Name:FAUSTO
Middle Name:X
Last Name:ALMEIDA
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8300 CEDAR HOLLOW LN
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-6812
Mailing Address - Country:US
Mailing Address - Phone:561-296-2345
Mailing Address - Fax:561-296-2346
Practice Address - Street 1:750 S FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-5767
Practice Address - Country:US
Practice Address - Phone:954-421-8181
Practice Address - Fax:954-426-2967
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA 9103419363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLQ67819Medicare UPIN
FLU72232ZMedicare PIN