Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | ME63408 | FL |
NPI | 1043326846 |
---|---|
Provider Name | Eileen Higgins Faradji |
First Address | Medley, FL 33178-1167 |
Second Address | Miami, FL 33176-2148 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2006 |
Last Update Date | 24/03/2021 |