MEDICARE: MR. BEHNAM BIRGANI DO

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	207QG0300X	Geriatric Medicine (Family Medicine) Physician	OS0007073	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	380001376	OTHER	FL	RAILROAD MEDICARE
3	8468488	OTHER	FL	MEDICARE NSC

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
4	27514	OTHER	FL	WELLCARE
5	249132	OTHER	FL	AVMED
6	57293	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1942381512
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BEHNAM BIRGANI DO

Provider Business Mailing Address
First Line	:	4611 S UNIVERSITY DR
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33328-3817
Country	:	US
Telephone Number	:	954-491-4888
Fax Number	:

Provider Business Practice Location Address
First Line	:	4602 N FEDERAL HWY
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-5206
Country	:	US
Telephone Number	:	954-491-4888
Fax Number	:	954-202-0504

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

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	02/28/2022

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Directions to “ MR. BEHNAM BIRGANI DO” Practice Location

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