Basic Information
| Provider Information | |||||||||
| NPI: | 1851354807 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FARADJI | ||||||||
| FirstName: | VICTOR | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 160010 | ||||||||
| Address2: | |||||||||
| City: | HIALEAH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330160001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055954041 | ||||||||
| FaxNumber: | 3055957799 | ||||||||
| Practice Location | |||||||||
| Address1: | 8940 N KENDALL DR | ||||||||
| Address2: | SUITE 802E | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331762148 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055954041 | ||||||||
| FaxNumber: | 3055956638 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/10/2006 | ||||||||
| LastUpdateDate: | 03/25/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/25/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | ME57122 | FL | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
No ID Information.