Provider Demographics
NPI:1417985888
Name:BEHARRIE, ASHRAF H (MD)
Entity Type:Individual
Prefix:
First Name:ASHRAF
Middle Name:H
Last Name:BEHARRIE
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 1:4330 W BROWARD BLVD
Mailing Address - Street 2:SUITE P
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-3775
Mailing Address - Country:US
Mailing Address - Phone:954-587-0631
Mailing Address - Fax:954-587-0633
Practice Address - Street 1:4330 W BROWARD BLVD
Practice Address - Street 2:SUITE P
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-3775
Practice Address - Country:US
Practice Address - Phone:954-587-0631
Practice Address - Fax:954-587-0632
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME69909208000000X, 2080P0204X, 2080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL252076100Medicaid
FL252076100Medicaid