=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528654696
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | FARZANA RASHID NP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/14/2020
-----------------------------------------------------
Last Update Date | 02/19/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1722 STATE ROAD 44
-----------------------------------------------------
City | NEW SMYRNA BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32168-8339
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 386-427-0390
-----------------------------------------------------
Fax | 386-427-0394
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 60 MADISON AVE
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10010-1600
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-545-2400
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 11019219
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------