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NPI Code Detail

MEDICARE: DR. BIJAN J BAKHTIAN M.D.

MEDICARE: DR. BIJAN J BAKHTIAN 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
1207T00000XNeurological Surgery PhysicianME57192FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ME57192OTHERFLMEDICAL LICENSE

General Provider Information

NPI Number : 1740256031
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BIJAN J BAKHTIAN M.D.
Provider Business Mailing Address
First Line : 2780 CLEVELAND AVE
Second Line : SUITE 819
City : FORT MYERS
State : FL
Zip : 33901-5858
Country : US
Telephone Number : 239-336-6800
Fax Number : 239-336-6993
Provider Business Practice Location Address
First Line : 2780 CLEVELAND AVE
Second Line : SUITE 819
City : FORT MYERS
State : FL
Zip : 33901-5858
Country : US
Telephone Number : 239-336-6800
Fax Number : 239-336-6993
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2006
Last Update Date : 02/14/2008

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