Healthcare Provider Details

I. General information

NPI: 1427208073
Provider Name (Legal Business Name): SAEID FARHADI MD PL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2008
Last Update Date: 10/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 W REYNOLDS ST
PLANT CITY FL
33563-4743
US

IV. Provider business mailing address

2001 W REYNOLDS ST
PLANT CITY FL
33563-4743
US

V. Phone/Fax

Practice location:
  • Phone: 813-719-8200
  • Fax:
Mailing address:
  • Phone: 813-719-8200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number StateFL

VIII. Authorized Official

Name: SAEID FARHADI
Title or Position: OWNER
Credential:
Phone: 813-719-8200