Provider Demographics
NPI:1033537865
Name:SIDDIQUI, FARHAN (MD)
Entity Type:Individual
Prefix:
First Name:FARHAN
Middle Name:
Last Name:SIDDIQUI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8702 HUNTERS LAKE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2855
Mailing Address - Country:US
Mailing Address - Phone:813-467-4700
Mailing Address - Fax:
Practice Address - Street 1:8702 HUNTERS LAKE DR STE 100
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-2855
Practice Address - Country:US
Practice Address - Phone:813-467-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-29
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA305899207Q00000X
FLME164165207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine