Provider Demographics
NPI:1073605838
Name:AKSU, ENGIN G (MD)
Entity Type:Individual
Prefix:
First Name:ENGIN
Middle Name:G
Last Name:AKSU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:E
Other - Middle Name:
Other - Last Name:AKSU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1219 SE 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316
Mailing Address - Country:US
Mailing Address - Phone:954-462-7022
Mailing Address - Fax:954-763-3172
Practice Address - Street 1:1219 SE 4TH AVE
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-1911
Practice Address - Country:US
Practice Address - Phone:954-462-7022
Practice Address - Fax:954-763-3172
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00193422084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
73103XMedicare ID - Type Unspecified
D86267Medicare UPIN
98951Medicare ID - Type UnspecifiedGROUP