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1851390983

NPI Code Detail

MEDICARE: DR. VIDA FARHANGI MD

MEDICARE: DR. VIDA FARHANGI 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
1	207R00000X	Internal Medicine Physician	ME 103260	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	4043245	OTHER		MEDICARE
6	P00121471	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7486229	OTHER	OH	AETNA
2	000000233015	OTHER	OH	ANTHEM & BLUE CROSS
3	1407806094	OTHER	FL	GROUP NPI
4	20-1841070	OTHER	FL	PRACTICE TAX ID
7	76-00115	OTHER	OH	UNITED HEALTH CARE
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	6199428002	OTHER	OH	CIGNA
10	D-78961	OTHER	OH	HUMANA
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851390983
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VIDA FARHANGI MD

Provider Business Mailing Address
First Line	:	PO BOX 863407
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32886-3407
Country	:	US
Telephone Number	:	941-917-2600
Fax Number	:	941-917-7884

Provider Business Practice Location Address
First Line	:	1825 DR MARTIN LUTHER KING WAY
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34234-2525
Country	:	US
Telephone Number	:	941-952-4123
Fax Number	:	941-952-4101

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

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	03/03/2020

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Directions to “ DR. VIDA FARHANGI MD” Practice Location

Language	Start Address	Practice Location

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