MEDICARE: FARAH EDDS MPAS, PA-C

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	363A00000X	Physician Assistant
2	363AM0700X	Medical Physician Assistant	PA9113471	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	:	1386191724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FARAH EDDS MPAS, PA-C

Provider Business Mailing Address
First Line	:	234 N RHODES AVE STE 105
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34237-4663
Country	:	US
Telephone Number	:	941-216-5115
Fax Number	:

Provider Business Practice Location Address
First Line	:	2970 UNIVERSITY PKWY STE 201
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34243-2401
Country	:	US
Telephone Number	:	941-216-5115
Fax Number	:

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

Provider Enumeration Date	:	09/01/2016
Last Update Date	:	04/27/2026

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