Provider Demographics
NPI:1114359700
Name:FAUSTIN, GUERRY (MD)
Entity Type:Individual
Prefix:DR
First Name:GUERRY
Middle Name:
Last Name:FAUSTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 N CONGRESS AVE STE 420
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-3458
Mailing Address - Country:US
Mailing Address - Phone:561-266-3487
Mailing Address - Fax:561-266-3447
Practice Address - Street 1:600 N CONGRESS AVE STE 420
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-3458
Practice Address - Country:US
Practice Address - Phone:561-266-3487
Practice Address - Fax:561-266-3447
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-06
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN669208D00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHV091AMedicare PIN