Provider Demographics
NPI:1326008848
Name:KASRA N BEHFAR DPM P A
Entity Type:Organization
Organization Name:KASRA N BEHFAR DPM P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KASRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BEHFAR
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:954-510-1003
Mailing Address - Street 1:9750 NW 33RD ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-4042
Mailing Address - Country:US
Mailing Address - Phone:954-510-1003
Mailing Address - Fax:954-510-1006
Practice Address - Street 1:50 NE 26TH AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-5239
Practice Address - Country:US
Practice Address - Phone:954-782-7071
Practice Address - Fax:954-510-1006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-27
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2505213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1224140003Medicare NSC