Healthcare Provider Details

I. General information

NPI: 1891727434
Provider Name (Legal Business Name): FARIDEH A ARBABZADEH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: FARIDEH A ZADEH MD

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 03/16/2022
Certification Date: 03/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

758 N SUN DR SUITE# 104
LAKE MARY FL
32746-2599
US

IV. Provider business mailing address

758 N SUN DR SUITE# 104
LAKE MARY FL
32746-2599
US

V. Phone/Fax

Practice location:
  • Phone: 407-333-3303
  • Fax: 407-333-3342
Mailing address:
  • Phone: 407-333-3303
  • Fax: 407-333-3342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License NumberME0074897
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME0074897
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: