Provider Demographics
NPI:1588975833
Name:MUSHTAQ, FARAAZ (DO)
Entity type:Individual
Prefix:DR
First Name:FARAAZ
Middle Name:
Last Name:MUSHTAQ
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1608 SE 3RD AVE
Mailing Address - Street 2:THIRD FLOOR, PBO
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-2564
Mailing Address - Country:US
Mailing Address - Phone:954-760-7171
Mailing Address - Fax:954-764-1722
Practice Address - Street 1:1600 S ANDREWS AVE
Practice Address - Street 2:1ST FL, ATRIUM HEART CENTER OF EXCELLENCE
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-2510
Practice Address - Country:US
Practice Address - Phone:954-760-7171
Practice Address - Fax:954-764-1722
Is Sole Proprietor?:No
Enumeration Date:2010-07-01
Last Update Date:2016-11-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOS14147207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL018804300Medicaid
FL018804300Medicaid