Provider Demographics
NPI:1275605321
Name:HAFFIZULLA, FARZANNA SHERENE (MD)
Entity Type:Individual
Prefix:DR
First Name:FARZANNA
Middle Name:SHERENE
Last Name:HAFFIZULLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:12555 ORANGE DR
Mailing Address - Street 2:SUITE 257
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33330-4304
Mailing Address - Country:US
Mailing Address - Phone:954-862-1778
Mailing Address - Fax:954-862-1779
Practice Address - Street 1:12555 ORANGE DR
Practice Address - Street 2:SUITE 257
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33330-4304
Practice Address - Country:US
Practice Address - Phone:954-862-1778
Practice Address - Fax:954-862-1779
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL0086693207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH89984Medicare UPIN
FL29185ZMedicare PIN