Provider Demographics
NPI:1376742114
Name:FARBER, STUART PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:PAUL
Last Name:FARBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3560 N 55TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-2342
Mailing Address - Country:US
Mailing Address - Phone:954-962-9311
Mailing Address - Fax:954-962-5826
Practice Address - Street 1:3990 SHERIDAN ST STE 210
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3656
Practice Address - Country:US
Practice Address - Phone:954-962-9311
Practice Address - Fax:954-962-5826
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-12
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL00403262086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL066591600Medicaid
FL94012Medicare UPIN