Provider Demographics
NPI:1376734269
Name:BRIDGES, KHARI HASAN (MD)
Entity Type:Individual
Prefix:DR
First Name:KHARI
Middle Name:HASAN
Last Name:BRIDGES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8950 SW 74TH CT STE 1413
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-3173
Mailing Address - Country:US
Mailing Address - Phone:305-670-0146
Mailing Address - Fax:305-670-8943
Practice Address - Street 1:8950 SW 74TH CT STE 1413
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-3173
Practice Address - Country:US
Practice Address - Phone:305-670-0146
Practice Address - Fax:305-670-8943
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME99204207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology