Healthcare Provider Details

I. General information

NPI: 1043326846
Provider Name (Legal Business Name): EILEEN HIGGINS FARADJI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8940 N KENDALL DR SUITE 802E
MIAMI FL
33176-2148
US

IV. Provider business mailing address

9960 NW 116TH WAY SUITE 13
MEDLEY FL
33178-1167
US

V. Phone/Fax

Practice location:
  • Phone: 305-595-4041
  • Fax: 305-595-6638
Mailing address:
  • Phone: 786-924-1311
  • Fax: 786-924-1313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME63408
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: