Healthcare Provider Details

I. General information

NPI: 1902269335
Provider Name (Legal Business Name): FORAT LUTFI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2016
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2330 SHAWNEE MISSION PKWY
WESTWOOD KS
66205-2005
US

IV. Provider business mailing address

PO BOX 100265
GAINESVILLE FL
32610-0265
US

V. Phone/Fax

Practice location:
  • Phone: 917-225-1359
  • Fax:
Mailing address:
  • Phone: 352-265-0239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number04-46373
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: