Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | ME132467 | FL |
Y | 207RI0011X | Interventional Cardiology | ME132467 | FL |
NPI | 1093942393 |
---|---|
Provider Name | Imran Sikander Farooq |
First Address | Orlando, FL 32804-5506 |
Second Address | Orlando, FL 32804-5506 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2009 |
Last Update Date | 06/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102767500 | (05) | FL |