Provider Demographics
NPI:1891727434
Name:ARBABZADEH, FARIDEH A (MD)
Entity Type:Individual
Prefix:DR
First Name:FARIDEH
Middle Name:A
Last Name:ARBABZADEH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:FARIDEH
Other - Middle Name:A
Other - Last Name:ZADEH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:758 N SUN DR
Mailing Address - Street 2:SUITE# 104
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-2599
Mailing Address - Country:US
Mailing Address - Phone:407-333-3303
Mailing Address - Fax:407-333-3342
Practice Address - Street 1:758 N SUN DR
Practice Address - Street 2:SUITE# 104
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-2599
Practice Address - Country:US
Practice Address - Phone:407-333-3303
Practice Address - Fax:407-333-3342
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0074897251K00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA254124600Medicaid
FLG13620Medicare UPIN
LA254124600Medicaid