Provider Demographics
NPI:1033484266
Name:RAHMAN, FARHANA (MD)
Entity Type:Individual
Prefix:DR
First Name:FARHANA
Middle Name:
Last Name:RAHMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1707 E BEARSS AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-2450
Mailing Address - Country:US
Mailing Address - Phone:813-550-0000
Mailing Address - Fax:813-800-9555
Practice Address - Street 1:1707 E BEARSS AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-2450
Practice Address - Country:US
Practice Address - Phone:813-550-0000
Practice Address - Fax:813-800-9555
Is Sole Proprietor?:No
Enumeration Date:2012-03-21
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME122588207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017298900Medicaid
FLP1893OtherHF MA