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General NPI Number Information
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NPI Number | 1982802823
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Entity Type | Individual
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Provider Name | FAROOQ LATEEF M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/03/2007
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Last Update Date | 05/22/2024
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Provider Practice Location Address
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Address Line | 6000 TURKEY LAKE RD SUITE 110
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City | ORLANDO
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State | FL
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Zip | 32819-4200
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Country | US
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Telephone | 407-351-1888
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Fax | 407-226-9804
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Provider Business Mailing Address
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Address Line | 2810 W SAINT ISABEL ST STE 201
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City | TAMPA
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State | FL
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Zip | 33607-6375
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Country | US
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Telephone | 813-890-8004
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Fax | 813-290-9691
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 75932
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License Number State | FL
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