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General NPI Number Information
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NPI Number | 1164662268
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Entity Type | Organization
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Legal Business Name | SANDRA D FARHADY ODPA
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Dates
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Enumeration Date | 03/02/2009
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Last Update Date | 03/02/2009
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Provider Practice Location Address
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Address Line | 7183 PEMBROKE RD
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City | PEMBROKE PINES
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State | FL
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Zip | 33023-2626
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Country | US
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Telephone | 954-981-5455
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Fax | 954-981-2020
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Provider Business Mailing Address
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Address Line | 4831 TAYLOR ST
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City | HOLLYWOOD
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State | FL
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Zip | 33021-5834
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Country | US
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Telephone | 954-983-1783
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Fax | 954-983-3179
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Authorized Official
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Title or Position | PRESIDENT
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Name | SANDRA D FARHADY
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Credential | OD
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Telephone | 954-983-1783
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC 3540
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License Number State | FL
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