Healthcare Provider Details

I. General information

NPI: 1043872823
Provider Name (Legal Business Name): NIDA FAROKH YUSUFALI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NIDA F YUSUFALI MD

II. Dates (important events)

Enumeration Date: 07/02/2019
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 WEKIVA COMMONS CIR
APOPKA FL
32712-3645
US

IV. Provider business mailing address

515 WEKIVA COMMONS CIR
APOPKA FL
32712-3645
US

V. Phone/Fax

Practice location:
  • Phone: 407-464-9516
  • Fax: 407-464-9519
Mailing address:
  • Phone: 407-464-9516
  • Fax: 407-464-9519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME164152
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME164152
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: