MEDICARE: FARINAZ NIROUMAND D.M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DN22213	FL

General Provider Information

NPI Number	:	1265987887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FARINAZ NIROUMAND D.M.D

Provider Business Mailing Address
First Line	:	6550 CARTMEL LN
Second Line	:
City	:	WINDERMERE
State	:	FL
Zip	:	34786-5423
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6550 CARTMEL LN
Second Line	:
City	:	WINDERMERE
State	:	FL
Zip	:	34786-5423
Country	:	US
Telephone Number	:	408-306-6842
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2016
Last Update Date	:	08/24/2016

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