Provider Demographics
NPI:1164185104
Name:FARROW, MICHAEL ONEAL II
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ONEAL
Last Name:FARROW
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2688 STONEWOOD PARK LOOP UNIT 1
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34638-6210
Mailing Address - Country:US
Mailing Address - Phone:813-481-9662
Mailing Address - Fax:
Practice Address - Street 1:2688 STONEWOOD PARK LOOP UNIT 1
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34638-6210
Practice Address - Country:US
Practice Address - Phone:813-481-9662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-18
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician