MEDICARE: JOHN K B AFSHAR MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207T00000X	Neurological Surgery Physician	ME68976	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245215409
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN K B AFSHAR MD

Provider Business Mailing Address
First Line	:	PO BOX 417
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34995-0417
Country	:	US
Telephone Number	:	772-223-2832
Fax Number	:	772-223-5646

Provider Business Practice Location Address
First Line	:	901 VILLAGE BLVD STE 702
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-1947
Country	:	US
Telephone Number	:	561-882-6214
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2005
Last Update Date	:	01/10/2020

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