Provider Demographics
NPI:1467432120
Name:FAROOQ, MUHAMMAD (MD)
Entity Type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:
Last Name:FAROOQ
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 1:777 37TH ST
Mailing Address - Street 2:SUITE A104
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-4873
Mailing Address - Country:US
Mailing Address - Phone:772-567-2277
Mailing Address - Fax:772-770-1737
Practice Address - Street 1:777 37TH ST
Practice Address - Street 2:SUITE A104
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-4873
Practice Address - Country:US
Practice Address - Phone:772-567-2277
Practice Address - Fax:772-770-1737
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30592207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL410113147OtherMEDICARE RAILROAD
FL800008535OtherFL LAB LIC
FL10D0860691OtherCLIA
FL059273100Medicaid
FL059273100Medicaid
FL31100Medicare ID - Type Unspecified
FL410113147OtherMEDICARE RAILROAD