Provider Demographics
NPI:1700249505
Name:FAROOQI, FARYAL IZHAR (MD)
Entity Type:Individual
Prefix:
First Name:FARYAL
Middle Name:IZHAR
Last Name:FAROOQI
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 1:4998 10TH AVE N
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-2210
Mailing Address - Country:US
Mailing Address - Phone:561-293-2900
Mailing Address - Fax:
Practice Address - Street 1:4998 10TH AVE N
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-2210
Practice Address - Country:US
Practice Address - Phone:561-293-2900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-30
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME139399207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine