Provider Demographics
NPI:1780856260
Name:CHEDDIE, FARIDA S (PA-C)
Entity Type:Individual
Prefix:
First Name:FARIDA
Middle Name:S
Last Name:CHEDDIE
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:3801 BISCAYNE BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-9800
Mailing Address - Country:US
Mailing Address - Phone:305-571-0620
Mailing Address - Fax:305-576-8099
Practice Address - Street 1:21097 NE 27TH CT
Practice Address - Street 2:SUITE 100
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1204
Practice Address - Country:US
Practice Address - Phone:305-792-0012
Practice Address - Fax:305-792-0030
Is Sole Proprietor?:No
Enumeration Date:2008-03-25
Last Update Date:2022-01-26
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Provider Licenses
StateLicense IDTaxonomies
FLPA9103176363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU4731ZMedicare UPIN