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General NPI Number Information
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NPI Number | 1063632040
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Entity Type | Organization
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Legal Business Name | FARAH FAMILY HEALTH CENTER INC
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 3049 CLEVELAND AVE SUITE 102
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City | FORT MYERS
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State | FL
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Zip | 33901-7049
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Country | US
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Telephone | 239-334-3545
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Fax | 239-334-6085
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Provider Business Mailing Address
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Address Line | PO BOX 9267
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City | FORT MYERS
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State | FL
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Zip | 33902-9267
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Country | US
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Telephone | 239-334-3545
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Fax | 239-334-6085
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. GUY P LARSEN
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Credential | MD
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Telephone | 239-334-3545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME0026178
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME0026178
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License Number State | FL
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