MEDICARE: DR. YARED AKLILU M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0200X	Infectious Disease Physician	ME73773	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225034986
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YARED AKLILU M.D.

Provider Business Mailing Address
First Line	:	4750 N FEDERAL HWY
Second Line	:	STE 200
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33308-4609
Country	:	US
Telephone Number	:	954-489-2260
Fax Number	:	954-489-2261

Provider Business Practice Location Address
First Line	:	4750 N FEDERAL HWY
Second Line	:	STE 200
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33308-4609
Country	:	US
Telephone Number	:	954-489-2260
Fax Number	:	954-489-2261

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2005
Last Update Date	:	12/22/2011

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