Provider Demographics
NPI:1063468122
Name:ALL SPECIALTY CARE PA
Entity Type:Organization
Organization Name:ALL SPECIALTY CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:BAHRAMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-583-5099
Mailing Address - Street 1:5595 ORANGE DR
Mailing Address - Street 2:SUITE 207
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-3817
Mailing Address - Country:US
Mailing Address - Phone:954-583-5099
Mailing Address - Fax:954-583-5168
Practice Address - Street 1:5595 ORANGE DR
Practice Address - Street 2:SUITE 207
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33314-3817
Practice Address - Country:US
Practice Address - Phone:954-583-5099
Practice Address - Fax:954-583-5168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME56556207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1568470417OtherINDIVIDUAL NPI
FL268559500Medicaid
FL062430600Medicaid
FLME56556OtherSTATE LICENSE
FLME56556OtherSTATE LICENSE
FLK4133Medicare PIN
FL09866Medicare PIN
FL1568470417OtherINDIVIDUAL NPI
FLE89680Medicare UPIN
FL268559500Medicaid
FL09866SMedicare PIN