MEDICARE: BEHNAM BIRGANI DO PA

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	207QG0300X	Geriatric Medicine (Family Medicine) Physician	OS0007073	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	380001376	OTHER	FL	RAILROAD MEDICARE

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
2	57393	OTHER	FL	BCBS
4	8468488	OTHER	FL	CIGNA
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619059995
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEHNAM BIRGANI DO PA

Provider Business Mailing Address
First Line	:	4611 S UNIVERSITY DR
Second Line	:	DAVIE, FL 33328
City	:	DAVIE
State	:	FL
Zip	:	33328-3817
Country	:	US
Telephone Number	:	954-491-4888
Fax Number	:

Provider Business Practice Location Address
First Line	:	4602 N FEDERAL HWY
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-5206
Country	:	US
Telephone Number	:	954-491-4888
Fax Number	:	954-202-0504

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	BEHNAM BIRGANI
Credential	:	DO
Telephone Number	:	954-491-4888

Provider Enumeration Date	:	10/19/2006
Last Update Date	:	06/04/2014

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Directions to “BEHNAM BIRGANI DO PA ” Practice Location

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