=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811103807
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SAEID FARHADI M.D. , P.L.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/15/2007
-----------------------------------------------------
Last Update Date | 07/20/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2001 W REYNOLDS ST
-----------------------------------------------------
City | PLANT CITY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33563-4743
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-719-8200
-----------------------------------------------------
Fax | 813-719-2900
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2001 W REYNOLDS ST
-----------------------------------------------------
City | PLANT CITY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33563-4743
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-719-8200
-----------------------------------------------------
Fax | 813-719-2900
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084N0400X
-----------------------------------------------------
Taxonomy Name | Neurology Physician
-----------------------------------------------------
License Number | ME100864
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------