Individual
DR. FARID GHARAGOZLOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6718 LAKE NONA BLVD, ORLANDO, FL 32827-7982
(407) 747-1899
Mailing address
5092 ISLEWORTH COUNTRY CLUB DR, WINDERMERE, FL 34786-8920
(202) 841-7304
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
20565
AZ
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
MD20785
DC
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
ME118239
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
026908500
—
DC
05
—
160861400
—
MD
01
—
3123363
MAMSI HEALTH & LIFE
DC
01
—
5318172
AETNA
AZ
01
—
53273804
CAREFIRST BLUESHEILD
MD
05
—
735245
—
AZ
01
—
J449-0001
CAREFIRST BLUESHIELD
DC
Enumeration date
06/08/2006
Last updated
08/16/2022
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