MEDICARE: FARRAH SHARIF

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	363AM0700X	Medical Physician Assistant	PA9119251	FL

General Provider Information

NPI Number	:	1750071957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FARRAH SHARIF

Provider Business Mailing Address
First Line	:	2870 E OAKLAND PARK BLVD
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33306-1814
Country	:	US
Telephone Number	:	954-663-7366
Fax Number	:	954-337-7968

Provider Business Practice Location Address
First Line	:	2870 E OAKLAND PARK BLVD STE 102
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33306-1814
Country	:	US
Telephone Number	:	954-666-3736
Fax Number	:	954-337-7968

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

Provider Enumeration Date	:	05/10/2023
Last Update Date	:	10/07/2024

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