Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | DN18160 | FL |
NPI | 1649405655 |
---|---|
Provider Name | Dr. Hameed R Farrokhrooz |
First Address | Brandon, FL 33511-6008 |
Second Address | Brandon, FL 33511-6008 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2009 |
Last Update Date | 19/05/2009 |