Healthcare Provider Details

I. General information

NPI: 1457795353
Provider Name (Legal Business Name): FRANK R. FAROKHI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2013
Last Update Date: 06/18/2021
Certification Date: 06/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5153 N 9TH AVE STE 302
PENSACOLA FL
32504-5719
US

IV. Provider business mailing address

4205 BELFORT RD STE 4015
JACKSONVILLE FL
32216-3623
US

V. Phone/Fax

Practice location:
  • Phone: 850-416-2250
  • Fax: 850-416-2536
Mailing address:
  • Phone: 904-450-6063
  • Fax: 904-450-6401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberME149912
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: