Healthcare Provider Details

I. General information

NPI: 1417985888
Provider Name (Legal Business Name): ASHRAF H BEHARRIE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 09/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4330 W BROWARD BLVD SUITE P
PLANTATION FL
33317-3775
US

IV. Provider business mailing address

4330 W BROWARD BLVD SUITE P
PLANTATION FL
33317-3775
US

V. Phone/Fax

Practice location:
  • Phone: 954-587-0631
  • Fax: 954-587-0632
Mailing address:
  • Phone: 954-587-0631
  • Fax: 954-587-0633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME69909
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License NumberME69909
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code2080P0210X
TaxonomyPediatric Nephrology Physician
License NumberME69909
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: