Provider Demographics
NPI:1720240187
Name:CHUONG, FARAH SULTAN (MD)
Entity type:Individual
Prefix:DR
First Name:FARAH
Middle Name:SULTAN
Last Name:CHUONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:FARAH
Other - Middle Name:LYNN
Other - Last Name:SULTAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8950 NORTH KENDALL DRIVE #103
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176
Mailing Address - Country:US
Mailing Address - Phone:305-596-4013
Mailing Address - Fax:305-596-4557
Practice Address - Street 1:8950 NORTH KENDALL DRIVE
Practice Address - Street 2:SUITE #103
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176
Practice Address - Country:US
Practice Address - Phone:305-596-4013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME111415207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL14KZ5OtherBLUE CROSS BLUE SHIELD
FL005916000Medicaid
FL14KZ5OtherBLUE CROSS BLUE SHIELD