Provider Demographics
NPI:1023026127
Name:BUSH, DARIN L (DO)
Entity Type:Individual
Prefix:MR
First Name:DARIN
Middle Name:L
Last Name:BUSH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 N FEDERAL HWY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33306-1018
Mailing Address - Country:US
Mailing Address - Phone:954-816-1301
Mailing Address - Fax:954-840-8254
Practice Address - Street 1:3101 N FEDERAL HWY
Practice Address - Street 2:SUITE 201
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33306-1018
Practice Address - Country:US
Practice Address - Phone:954-816-1301
Practice Address - Fax:954-840-8254
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8691207Q00000X, 208100000X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU1187Medicare PIN
H92245Medicare UPIN