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NPI Code Detail

MEDICARE: DR. BEHROUZ MADANI M.D.

MEDICARE: DR. BEHROUZ MADANI 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
1174400000XSpecialistME26731FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
251076OTHERFLBCBS

General Provider Information

NPI Number : 1477556272
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BEHROUZ MADANI M.D.
Provider Business Mailing Address
First Line : PO BOX 1177
Second Line :
City : DADE CITY
State : FL
Zip : 33526-1177
Country : US
Telephone Number : 352-521-1569
Fax Number : 352-521-1579
Provider Business Practice Location Address
First Line : 13540 17TH ST
Second Line :
City : DADE CITY
State : FL
Zip : 33525-5244
Country : US
Telephone Number : 352-567-1411
Fax Number : 352-567-6391
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2005
Last Update Date : 02/23/2011

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