Healthcare Provider Details

I. General information

NPI: 1063557940
Provider Name (Legal Business Name): RIZWANA FAREEDUDDIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 01/30/2023
Certification Date: 01/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2415 N ORANGE AVE
ORLANDO FL
32804-5505
US

IV. Provider business mailing address

2415 N ORANGE AVE STE 402
ORLANDO FL
32804-5505
US

V. Phone/Fax

Practice location:
  • Phone: 407-622-0560
  • Fax:
Mailing address:
  • Phone: 407-622-0560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME118539
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberME118539
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: