Individual
MRS. SHAHEEN FARUQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2351 AARON ST, PORT CHARLOTTE, FL 33952-5305
(855) 979-5700
(855) 979-5701
Mailing address
2675 WINKLER AVE FL 2, FORT MYERS, FL 33901-9342
(877) 856-3774
(239) 599-2612
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME95171
FL
208M00000X
Hospitalist Physician
Primary
ME95171
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
280098500
—
FL
01
—
56582
BC/BS
FL
Enumeration date
09/25/2006
Last updated
10/08/2019
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