MEDICARE: FARZAD M ESFAHANI MD PA

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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	ME68692	FL

General Provider Information

NPI Number	:	1649471806
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FARZAD M ESFAHANI MD PA

Provider Business Mailing Address
First Line	:	2443 QUANTUM BLVD
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33426-8612
Country	:	US
Telephone Number	:	561-738-1051
Fax Number	:	561-742-5626

Provider Business Practice Location Address
First Line	:	2443 QUANTUM BLVD
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33426-8612
Country	:	US
Telephone Number	:	561-738-1051
Fax Number	:	561-742-5626

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. FARZAD M. ESFAHANI
Credential	:	MD
Telephone Number	:	561-738-1051

Provider Enumeration Date	:	05/29/2007
Last Update Date	:	01/29/2008

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