MEDICARE: DR. STUART PAUL FARBER 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	2086S0129X	Vascular Surgery Physician	0040326	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376742114
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STUART PAUL FARBER M.D.

Provider Business Mailing Address
First Line	:	3560 N 55TH AVE
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-2342
Country	:	US
Telephone Number	:	954-962-9311
Fax Number	:	954-962-5826

Provider Business Practice Location Address
First Line	:	3990 SHERIDAN ST STE 210
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-3656
Country	:	US
Telephone Number	:	954-962-9311
Fax Number	:	954-962-5826

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

Provider Enumeration Date	:	07/12/2007
Last Update Date	:	06/02/2016

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