MEDICARE: DR. LOUIS HAFKEN 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	2084P0800X	Psychiatry Physician	MD04782	RI
2	2084P0800X	Psychiatry Physician	52161	MA
3	2084P0800X	Psychiatry Physician	ME77043	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
2	295422	OTHER	RI	BLUE CROSS BLUE SHIELD
3	1528859	OTHER	RI	UNITED BEHAVIORAL HEALTH
4	003054	OTHER	RI	BLUE CHIP

General Provider Information

NPI Number	:	1366544439
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOUIS HAFKEN MD

Provider Business Mailing Address
First Line	:	3934 SHERWOOD BLVD
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33445-5655
Country	:	US
Telephone Number	:	561-445-9361
Fax Number	:	561-499-4275

Provider Business Practice Location Address
First Line	:	16158 S MILITARY TRL
Second Line	:	SOUTH COUNTY MENTAL HEALTH CENTER
City	:	DELRAY BEACH
State	:	FL
Zip	:	33484-6502
Country	:	US
Telephone Number	:	561-495-0522
Fax Number	:

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

Provider Enumeration Date	:	09/01/2006
Last Update Date	:	04/25/2013

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Directions to “ DR. LOUIS HAFKEN MD” Practice Location

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