Provider Demographics
NPI:1376830125
Name:FARAJ, KIRMANJ MUHAMMAD (MD)
Entity type:Individual
Prefix:
First Name:KIRMANJ
Middle Name:MUHAMMAD
Last Name:FARAJ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:KIRMANJ
Other - Middle Name:M
Other - Last Name:FARAJ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:803 E DIXIE AVE
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-6013
Mailing Address - Country:US
Mailing Address - Phone:352-530-2256
Mailing Address - Fax:352-315-0166
Practice Address - Street 1:803 E DIXIE AVE
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-6013
Practice Address - Country:US
Practice Address - Phone:352-530-2256
Practice Address - Fax:352-315-0166
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101281951207RI0011X, 207RC0000X
FLME141759207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology