Provider Demographics
NPI:1982767265
Name:IRANI, FARHAD S (MD)
Entity type:Individual
Prefix:
First Name:FARHAD
Middle Name:S
Last Name:IRANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 8TH ST N
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5519
Mailing Address - Country:US
Mailing Address - Phone:239-261-5511
Mailing Address - Fax:239-649-3301
Practice Address - Street 1:400 8TH ST N
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5519
Practice Address - Country:US
Practice Address - Phone:239-261-5511
Practice Address - Fax:239-649-3301
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2009-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME78642207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL110194524OtherRRMC
FL257263000Medicaid
FL47062OtherBCBS
FL257263000Medicaid
FL110194524OtherRRMC