Healthcare Provider Details

I. General information

NPI: 1336389592
Provider Name (Legal Business Name): YASMIN AKHTAR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2009
Last Update Date: 07/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 NE 19TH DR
OKEECHOBEE FL
34972-1932
US

IV. Provider business mailing address

202 N.E. 19TH DRIVE
OKEECHOBEE FL
34972-1932
US

V. Phone/Fax

Practice location:
  • Phone: 863-357-6030
  • Fax: 863-357-3654
Mailing address:
  • Phone: 863-357-6030
  • Fax: 863-357-3654

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberME102932
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: