Provider Demographics
NPI:1962722348
Name:BTNGHAFOOR LLC
Entity type:Organization
Organization Name:BTNGHAFOOR LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HALIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:GHAFOOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-331-0885
Mailing Address - Street 1:11435 BELLE HAVEN DR
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34654-4435
Mailing Address - Country:US
Mailing Address - Phone:727-859-4362
Mailing Address - Fax:727-859-4389
Practice Address - Street 1:2051 LITTLE RD
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-4421
Practice Address - Country:US
Practice Address - Phone:727-859-4362
Practice Address - Fax:727-859-4389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-08
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME100982207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000296600Medicaid