Provider Demographics
NPI:1447921697
Name:BUCHILLON, FARADAY
Entity type:Individual
Prefix:MR
First Name:FARADAY
Middle Name:
Last Name:BUCHILLON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:FARDAY
Other - Middle Name:
Other - Last Name:BUCHILLON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:14921 SW 82ND TER APT 206
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-1494
Mailing Address - Country:US
Mailing Address - Phone:786-442-6240
Mailing Address - Fax:
Practice Address - Street 1:7711 N MILITARY TRL STE 1018
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33410-6506
Practice Address - Country:US
Practice Address - Phone:561-460-0284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-27
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician