Organization
FARGHALY MEDICAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA BURNSIDE (OFFICE MANAGER)
(904) 826-7932
Entity
Organization
Contact information
Practice address
100 WHETSTONE PL, SUITE 208, ST AUGUSTINE, FL 32086-5774
(904) 826-7932
(904) 819-6700
Mailing address
100 WHETSTONE PL, SUITE 208, ST AUGUSTINE, FL 32086-5774
(904) 826-7932
(904) 819-6700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME97900
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
PENDING
FL
Enumeration date
11/11/2014
Last updated
11/11/2014
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