Provider Demographics
NPI:1902023716
Name:AKHTER, BUSHRA (MD)
Entity Type:Individual
Prefix:DR
First Name:BUSHRA
Middle Name:
Last Name:AKHTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10000 W COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-3400
Mailing Address - Country:US
Mailing Address - Phone:321-843-1378
Mailing Address - Fax:321-843-5177
Practice Address - Street 1:10000 W COLONIAL DR
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761
Practice Address - Country:US
Practice Address - Phone:321-843-1378
Practice Address - Fax:321-843-5177
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 111723208M00000X
FLME111723207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008715700Medicaid
MS08328562Medicaid
FL14NA2OtherBCBS FL
FLP01434086OtherRR MEDICARE
MSP00466880OtherRAIL ROAD MEDICARE
FL008715700Medicaid
FLP01434086OtherRR MEDICARE
MS08328562Medicaid
FL008715700Medicaid