Provider Demographics
NPI:1902123268
Name:FARIN, DAVID (LMT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:FARIN
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 THREES ISLANDS BLVD
Mailing Address - Street 2:APT 204
Mailing Address - City:HALLANDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33009
Mailing Address - Country:US
Mailing Address - Phone:786-346-3308
Mailing Address - Fax:
Practice Address - Street 1:871 W OAKLAND PARK BLVD
Practice Address - Street 2:101
Practice Address - City:WILTON MANORS
Practice Address - State:FL
Practice Address - Zip Code:33311-1731
Practice Address - Country:US
Practice Address - Phone:954-567-5730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-27
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA49314225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist