Provider Demographics
NPI:1710279591
Name:FAROOQUI, SADIYA AHMED (DO)
Entity type:Individual
Prefix:DR
First Name:SADIYA
Middle Name:AHMED
Last Name:FAROOQUI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:425 W COLONIAL DR STE 303
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-6863
Mailing Address - Country:US
Mailing Address - Phone:321-332-6947
Mailing Address - Fax:407-286-4515
Practice Address - Street 1:9740 N 56TH ST STE B
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33617-5500
Practice Address - Country:US
Practice Address - Phone:813-200-7717
Practice Address - Fax:813-985-8500
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-11
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS13341207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL102158900Medicaid
FLOS13341OtherD.O. LICENSE