Provider Demographics
NPI:1558771238
Name:FARUQI, ADNAN (MD)
Entity Type:Individual
Prefix:
First Name:ADNAN
Middle Name:
Last Name:FARUQI
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 1:1301 PLANTATION ISLAND DR S STE 302A
Mailing Address - Street 2:
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32080-3117
Mailing Address - Country:US
Mailing Address - Phone:904-461-9330
Mailing Address - Fax:904-461-9331
Practice Address - Street 1:1301 PLANTATION ISLAND DR S STE 302A
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32080-3117
Practice Address - Country:US
Practice Address - Phone:312-646-0660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-02
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME140144207LP2900X, 207L00000X
MA260520208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No208600000XAllopathic & Osteopathic PhysiciansSurgery