Provider Demographics
NPI:1942370002
Name:NAZARALLY, FARIDA RAHIM (MD)
Entity Type:Individual
Prefix:
First Name:FARIDA
Middle Name:RAHIM
Last Name:NAZARALLY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:FARIDA
Other - Middle Name:
Other - Last Name:RAHIM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:19590 OLD CUTLER RD
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-8048
Mailing Address - Country:US
Mailing Address - Phone:786-466-3500
Mailing Address - Fax:786-466-3889
Practice Address - Street 1:19590 OLD CUTLER RD
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-8048
Practice Address - Country:US
Practice Address - Phone:786-466-3500
Practice Address - Fax:786-466-3889
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME78284207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBR6549351OtherDEA
FLH38819Medicare UPIN