Provider Demographics
NPI:1730352535
Name:FAKHOURY, FARIS J (MD)
Entity type:Individual
Prefix:DR
First Name:FARIS
Middle Name:J
Last Name:FAKHOURY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10115 W. FOREST HILL BLVD.
Mailing Address - Street 2:SUITE 405
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414
Mailing Address - Country:US
Mailing Address - Phone:561-791-3070
Mailing Address - Fax:561-791-3080
Practice Address - Street 1:10115 W. FOREST HILL BLVD.
Practice Address - Street 2:SUITE 405
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414
Practice Address - Country:US
Practice Address - Phone:561-791-3070
Practice Address - Fax:561-791-3080
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-12
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME 106083207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery