Healthcare Provider Details

I. General information

NPI: 1285084533
Provider Name (Legal Business Name): EYAD EL FAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: EYAD RAWHI EL FAR

II. Dates (important events)

Enumeration Date: 06/17/2016
Last Update Date: 06/23/2023
Certification Date: 06/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40100 HIGHWAY 27
DAVENPORT FL
33837-5906
US

IV. Provider business mailing address

7531 S STONY ISLAND AVE
CHICAGO IL
60649-3954
US

V. Phone/Fax

Practice location:
  • Phone: 863-422-4971
  • Fax: 863-419-2264
Mailing address:
  • Phone: 773-947-7500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number125.069393
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME140933
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME140933
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: