Healthcare Provider Details

I. General information

NPI: 1891229126
Provider Name (Legal Business Name): IFRAH ZAHID BUTT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2017
Last Update Date: 08/09/2021
Certification Date: 08/09/2021
Deactivation Date: 11/17/2017
Reactivation Date: 12/12/2017

III. Provider practice location address

20900 BISCAYNE BLVD.
AVENTURA FL
33180
US

IV. Provider business mailing address

20900 BISCAYNE BLVD.
AVENTURA FL
33180
US

V. Phone/Fax

Practice location:
  • Phone: 305-682-7000
  • Fax:
Mailing address:
  • Phone: 305-682-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberTRN25670
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberTRN25670
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: