Individual
ABUBAKER SHADOUL MOHAMED FARAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 WATERMAN WAY, TAVARES, FL 32778-5266
(352) 742-3578
(352) 742-3581
Mailing address
770 W GRANADA BLVD STE 101, ORMOND BEACH, FL 32174-5179
(386) 231-4746
(386) 368-8927
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME171818
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/25/2022
Last updated
08/25/2025
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