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NPI Code Detail

MEDICARE: DR. BASHAR LUTFI M.D.

MEDICARE: DR. BASHAR LUTFI M.D.
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
12084N0400XNeurology PhysicianME 79552FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
135396YOTHERFLMEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1548483761
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BASHAR LUTFI M.D.
Provider Business Mailing Address
First Line : 9397 SATINLEAF PL
Second Line :
City : PARKLAND
State : FL
Zip : 33076-3960
Country : US
Telephone Number : 954-756-0615
Fax Number :
Provider Business Practice Location Address
First Line : 1725 N UNIVERSITY DR STE 425
Second Line :
City : CORAL SPRINGS
State : FL
Zip : 33071-6000
Country : US
Telephone Number : 305-259-0092
Fax Number : 786-545-7627
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2007
Last Update Date : 11/24/2021

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