Provider Demographics
NPI:1679576581
Name:AHMED, FARHANA (MD)
Entity type:Individual
Prefix:DR
First Name:FARHANA
Middle Name:
Last Name:AHMED
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 1:6130 NW 124TH DR
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33076-1916
Mailing Address - Country:US
Mailing Address - Phone:954-227-4080
Mailing Address - Fax:954-757-7787
Practice Address - Street 1:6103 NW 124TH DR
Practice Address - Street 2:CORAL SPRINGS
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33076-1916
Practice Address - Country:US
Practice Address - Phone:954-227-4080
Practice Address - Fax:954-757-7787
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME75842207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL254441500Medicaid
FL254441500Medicaid
FL43994BMedicare PIN