Provider Demographics
NPI:1912955246
Name:FELDER, FAITH (MD)
Entity Type:Individual
Prefix:
First Name:FAITH
Middle Name:
Last Name:FELDER
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:PO BOX 172266
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33672-1228
Mailing Address - Country:US
Mailing Address - Phone:813-872-8600
Mailing Address - Fax:
Practice Address - Street 1:4144 N ARMENIA AVE STE 210
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6447
Practice Address - Country:US
Practice Address - Phone:813-872-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME74147207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLEO642YOtherMEDICARE
FLEO642YOtherMEDICARE