Provider Demographics
NPI:1619783206
Name:FIRST PATIENT CARE CLINIC @ RIVIERA
Entity type:Organization
Organization Name:FIRST PATIENT CARE CLINIC @ RIVIERA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GUERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:FAUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-266-3487
Mailing Address - Street 1:4431 WESTROADS DR
Mailing Address - Street 2:
Mailing Address - City:RIVIERA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-1207
Mailing Address - Country:US
Mailing Address - Phone:561-469-1959
Mailing Address - Fax:
Practice Address - Street 1:4431 WESTROADS DR
Practice Address - Street 2:
Practice Address - City:RIVIERA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-1207
Practice Address - Country:US
Practice Address - Phone:561-469-1959
Practice Address - Fax:561-266-3447
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FIRST PATIENT CARE CLINIC, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care