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NPI Code Detail

MEDICARE: BASHAR LUTFI MD PA

MEDICARE: BASHAR LUTFI MD PA
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
1AJ151OTHERFLMEDICARE PTAN

General Provider Information

NPI Number : 1740458371
Entity Type Code : Organization
Provider Name (Legal Business Name) : BASHAR LUTFI MD PA
Provider Business Mailing Address
First Line : 9397 SATINLEAF PL
Second Line :
City : PARKLAND
State : FL
Zip : 33076-3960
Country : US
Telephone Number : 305-259-0092
Fax Number : 786-545-7627
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 : PRESIDENT
Name : BASHAR LUTFI
Credential : MD
Telephone Number : 954-756-0615
Provider Enumeration Date : 02/17/2008
Last Update Date : 11/24/2021

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