Provider Demographics
NPI:1811103807
Name:FARHADI, SAEID (MD , PL)
Entity type:Individual
Prefix:
First Name:SAEID
Middle Name:
Last Name:FARHADI
Suffix:
Gender:M
Credentials:MD , PL
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Other - First Name:
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Mailing Address - Street 1:2001 W REYNOLDS ST
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33563-4743
Mailing Address - Country:US
Mailing Address - Phone:813-719-8200
Mailing Address - Fax:813-719-2900
Practice Address - Street 1:2001 W REYNOLDS ST
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-4743
Practice Address - Country:US
Practice Address - Phone:813-719-8200
Practice Address - Fax:813-719-2900
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME1008642084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000430800Medicaid
FL53221OtherBCBS