Provider Demographics
NPI:1942458252
Name:FALTAS, WAEL FATHY GAYD (MD)
Entity Type:Individual
Prefix:
First Name:WAEL
Middle Name:FATHY GAYD
Last Name:FALTAS
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 1:7657 CITA LN UNIT 101
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34653-6221
Mailing Address - Country:US
Mailing Address - Phone:727-233-1118
Mailing Address - Fax:
Practice Address - Street 1:7657 CITA LN UNIT 101
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653-6221
Practice Address - Country:US
Practice Address - Phone:727-233-1118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-29
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME111714207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004522300Medicaid
FL004522300Medicaid