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General NPI Number Information
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NPI Number | 1104359058
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Entity Type | Individual
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Provider Name | MALIK FAKHAR MD
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Gender | Male
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Dates
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Enumeration Date | 04/07/2017
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Last Update Date | 10/17/2025
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Provider Practice Location Address
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Address Line | 1 W SAMPLE RD STE 104
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City | DEERFIELD BEACH
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State | FL
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Zip | 33064-3547
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Country | US
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Telephone | 954-786-5151
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Fax | 954-786-2311
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Provider Business Mailing Address
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Address Line | 1608 SE 3RD AVE FL 3
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City | FORT LAUDERDALE
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State | FL
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Zip | 33316-2564
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Country | US
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Telephone | 954-786-5151
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Fax | 954-786-2311
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | ME162519
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | ME162519
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License Number State | FL
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