Healthcare Provider Details

I. General information

NPI: 1639126642
Provider Name (Legal Business Name): MUHAMMAD H. FAROOQI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1840 MEASE DR SUITE 104
SAFETY HARBOR FL
34695-6602
US

IV. Provider business mailing address

PO BOX 1698
CLEARWATER FL
33757-1698
US

V. Phone/Fax

Practice location:
  • Phone: 727-725-6283
  • Fax: 727-725-6215
Mailing address:
  • Phone: 727-532-0002
  • Fax: 727-532-1318

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberME76115
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: