Provider Demographics
NPI:1659326353
Name:FARBOWITZ, STEVEN (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:FARBOWITZ
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 1:590 MALABAR ROAD
Mailing Address - Street 2:SUITE 6 &7
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32907-3108
Mailing Address - Country:US
Mailing Address - Phone:321-676-3535
Mailing Address - Fax:321-676-3575
Practice Address - Street 1:590 MALABAR ROAD
Practice Address - Street 2:SUITE 6 &7
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32907-3108
Practice Address - Country:US
Practice Address - Phone:321-676-3535
Practice Address - Fax:321-676-3575
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA033089E207Q00000X
FLME116418207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01191401OtherCBC
PA0040795001OtherIBC
PA0990185OtherKHPC
B37558Medicare UPIN
PA0040795001OtherIBC