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Individual

FARAH SIDDIQUAH PERSAD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
601 GRAY AVE, WILDWOOD, FL 34785-3520
(352) 492-5611
Mailing address
601 GRAY AVE, WILDWOOD, FL 34785-3520
(352) 492-5611

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9108925
FL
363A00000X
Physician Assistant
PAT9108925
FL

Other

Enumeration date
09/05/2015
Last updated
10/19/2023
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