Provider Demographics
NPI:1689883431
Name:TARAFDAR HAGHIGHAT, SHAHRZAD (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAHRZAD
Middle Name:
Last Name:TARAFDAR HAGHIGHAT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:861 OAKLEY SEAVER DR
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-1968
Mailing Address - Country:US
Mailing Address - Phone:352-394-7125
Mailing Address - Fax:352-394-2584
Practice Address - Street 1:861 OAKLEY SEAVER DR
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-1968
Practice Address - Country:US
Practice Address - Phone:352-394-7125
Practice Address - Fax:352-394-2584
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME124165208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03258968Medicaid
FL020409100Medicaid
PA1025153430001Medicaid