Provider Demographics
NPI:1578548590
Name:FARAHMANDFAR, SAEED (MD)
Entity Type:Individual
Prefix:
First Name:SAEED
Middle Name:
Last Name:FARAHMANDFAR
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 1:6101 BLUE LAGOON DR STE 400
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2051
Mailing Address - Country:US
Mailing Address - Phone:305-500-2000
Mailing Address - Fax:
Practice Address - Street 1:9121 N MILITARY TRL STE 111
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-5985
Practice Address - Country:US
Practice Address - Phone:561-626-7604
Practice Address - Fax:561-626-1506
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-13
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0076257207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL257396200Medicaid
FL257396200Medicaid
44304BMedicare ID - Type Unspecified