Provider Demographics
NPI:1093373573
Name:ABDOLLAHI, FARKHONDEH
Entity Type:Individual
Prefix:
First Name:FARKHONDEH
Middle Name:
Last Name:ABDOLLAHI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5028 HUMMINGBIRD LN
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-7526
Mailing Address - Country:US
Mailing Address - Phone:214-780-8344
Mailing Address - Fax:
Practice Address - Street 1:5201 NW 34TH BLVD # 27540
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-1153
Practice Address - Country:US
Practice Address - Phone:352-240-1136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-30
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL34561225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist