Individual
FARRUKH AMBAREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7109 NW 11TH PL STE A, GAINESVILLE, FL 32605-3141
(352) 331-2890
(352) 331-2915
Mailing address
7109 NW 11TH PLACE, SUITE A, GAINESVILLE, FL 32605
(352) 331-2890
(352) 331-2915
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4301074916
MI
207R00000X
Internal Medicine Physician
Primary
4301074916
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1001400042
BCBSM
MI
05
—
104473348
—
MI
05
—
104473357
—
MI
05
—
104474917
—
MI
01
—
700A460030
BCBSM - GROUP
MI
Enumeration date
08/22/2005
Last updated
07/21/2022
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