Provider Demographics
NPI:1265896567
Name:DARIN L BUSH, D.O., P.A.
Entity type:Organization
Organization Name:DARIN L BUSH, D.O., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DARIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:BUSH
Authorized Official - Suffix:
Authorized Official - Credentials:DO,
Authorized Official - Phone:954-816-1301
Mailing Address - Street 1:3101 N FEDERAL HWY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33306-1018
Mailing Address - Country:US
Mailing Address - Phone:954-816-1301
Mailing Address - Fax:954-840-8254
Practice Address - Street 1:3101 N FEDERAL HWY
Practice Address - Street 2:SUITE 201
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33306-1018
Practice Address - Country:US
Practice Address - Phone:954-816-1301
Practice Address - Fax:954-840-8254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS86912081N0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081N0008XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationNeuromuscular MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOS8691OtherSTATE LIC
FLBB7942546OtherDEA