Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | ME135544 | FL |
NPI | 1003200932 |
---|---|
Provider Name | Sonia Farooqi |
First Address | Tampa, FL 33647-2211 |
Second Address | Lutz, FL 33549 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2015 |
Last Update Date | 30/06/2018 |