Provider Demographics
NPI:1770059693
Name:FACULTY ASSOCIATES, INC
Entity type:Organization
Organization Name:FACULTY ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SWEITZER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-273-5787
Mailing Address - Street 1:PO BOX 100425
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0425
Mailing Address - Country:US
Mailing Address - Phone:352-273-5801
Mailing Address - Fax:352-392-3070
Practice Address - Street 1:7505 GRAND LELY DR
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34113-1753
Practice Address - Country:US
Practice Address - Phone:352-273-5801
Practice Address - Fax:352-392-3070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-18
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0739693Medicaid