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NPI Code Detail

MEDICARE: REHAN AHMAD FAROOQUI MD

MEDICARE: REHAN AHMAD FAROOQUI MD
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
12084P0800XPsychiatry PhysicianME0098067FL

General Provider Information

NPI Number : 1639393259
Entity Type Code : Individual
Provider Name (Legal Business Name) : REHAN AHMAD FAROOQUI MD
Provider Business Mailing Address
First Line : 400 E SHERIDAN RD
Second Line :
City : MELBOURNE
State : FL
Zip : 32901-3184
Country : US
Telephone Number : 321-722-5200
Fax Number :
Provider Business Practice Location Address
First Line : 400 E SHERIDAN RD
Second Line :
City : MELBOURNE
State : FL
Zip : 32901-3184
Country : US
Telephone Number : 321-722-5200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2007
Last Update Date : 03/26/2021

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