Healthcare Provider Details

I. General information

NPI: 1720240187
Provider Name (Legal Business Name): FARAH SULTAN CHUONG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: FARAH LYNN SULTAN MD

II. Dates (important events)

Enumeration Date: 06/27/2008
Last Update Date: 12/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8950 NORTH KENDALL DRIVE SUITE #103
MIAMI FL
33176
US

IV. Provider business mailing address

8950 NORTH KENDALL DRIVE #103
MIAMI FL
33176
US

V. Phone/Fax

Practice location:
  • Phone: 305-596-4013
  • Fax:
Mailing address:
  • Phone: 305-596-4013
  • Fax: 305-596-4557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME111415
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: