Provider Demographics
NPI:1356592786
Name:DARVISH, FARIBA F (RPH, PARMD, CPH)
Entity type:Individual
Prefix:DR
First Name:FARIBA
Middle Name:F
Last Name:DARVISH
Suffix:
Gender:F
Credentials:RPH, PARMD, CPH
Other - Prefix:DR
Other - First Name:FAITH
Other - Middle Name:
Other - Last Name:DARVISH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH, PHARMD
Mailing Address - Street 1:2017 SACRAMENTO
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-2347
Mailing Address - Country:US
Mailing Address - Phone:954-609-6047
Mailing Address - Fax:954-888-9029
Practice Address - Street 1:2017 SACRAMENTO
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-2347
Practice Address - Country:US
Practice Address - Phone:954-609-6047
Practice Address - Fax:954-633-4156
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-03
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPU48491835G0303X
FLPS0302081835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835G0303XPharmacy Service ProvidersPharmacistGeriatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL285529OtherNABP
FLPS030208OtherPHARMACY LICENSE