Provider Demographics
NPI:1881655280
Name:AYDIN, FARUK (MD)
Entity Type:Individual
Prefix:
First Name:FARUK
Middle Name:
Last Name:AYDIN
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 1:9225 BAY PLAZA BLVD
Mailing Address - Street 2:SUITE # 418
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-4466
Mailing Address - Country:US
Mailing Address - Phone:813-649-8026
Mailing Address - Fax:813-425-5760
Practice Address - Street 1:9225 BAY PLAZA BLVD
Practice Address - Street 2:SUITE # 418
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-4466
Practice Address - Country:US
Practice Address - Phone:813-649-8026
Practice Address - Fax:813-425-5760
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79555207ZP0102X
TXK7984207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG18360Medicare UPIN