MEDICARE: DR. SHIRAZ FAROOQ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086S0102X	Surgical Critical Care Physician	MD19555	ME
2	208C00000X	Colon & Rectal Surgery Physician	MD19555	ME
3	208C00000X	Colon & Rectal Surgery Physician	ME108308	FL
4	208600000X	Surgery Physician	MD19555	ME
5	208600000X	Surgery Physician	ME108308	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	149U4	OTHER	FL	BLUE CROSS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205970431
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHIRAZ FAROOQ MD

Provider Business Mailing Address
First Line	:	PO BOX 4386
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33677-4386
Country	:	US
Telephone Number	:	813-278-6430
Fax Number	:	855-832-3509

Provider Business Practice Location Address
First Line	:	2313 W VIOLET ST STE A
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33603-1421
Country	:	US
Telephone Number	:	813-278-6430
Fax Number	:	855-832-3509

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/19/2007
Last Update Date	:	01/03/2025

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Directions to “ DR. SHIRAZ FAROOQ MD” Practice Location

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