Jack Sol Faintuch, MD
Individual provider Active NPI Specialist · Highland Beach, FL
NPI 1336396753 · NPPES record last updated Aug 27, 2008
Key facts
- NPI
- 1336396753
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- ME56702 (FL)
- Practice address
- 1011 Grand Court
Highland Beach, FL 33487 - Phone
- (561) 271-2500
- Fax
- (561) 620-3004
- NPI assigned
- Aug 27, 2008
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME56702 | FL | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | ME56702 | FL | Yes |
Addresses
Primary practice location
1011 Grand Court
Highland Beach, FL 33487
Mailing address
1011 Grand Court
Highland Beach, FL 33487
Phone (561) 271-2500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 062595700 | Medicaid | FL |
Other providers in Highland Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 27, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.