Provider Demographics
NPI:1316246739
Name:BASHIR, ATIF (MD)
Entity type:Individual
Prefix:DR
First Name:ATIF
Middle Name:
Last Name:BASHIR
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:PO BOX 939
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-0939
Mailing Address - Country:US
Mailing Address - Phone:561-793-6100
Mailing Address - Fax:561-793-1974
Practice Address - Street 1:1447 MEDICAL PARK BLVD STE 101
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-3164
Practice Address - Country:US
Practice Address - Phone:561-753-0001
Practice Address - Fax:561-753-0005
Is Sole Proprietor?:No
Enumeration Date:2011-03-24
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY280623207R00000X
FLME138594207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease