Individual
DR. BIJAN BAVARIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4725 N. FEDERAL HIGHWAY, FORT LAUDERDALE, FL 33308-4603
(954) 771-8000
(954) 773-3270
Mailing address
PO BOX 551420, FORT LAUDERDALE, FL 33355-1420
(800) 243-3839
(855) 851-4405
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
036086247
IL
207L00000X
Anesthesiology Physician
Primary
ME61491
FL
207LP2900X
Pain Medicine (Anesthesiology) Physician
036086247
IL
207Q00000X
Family Medicine Physician
036086247
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000575500
—
FL
05
—
036086247
—
IL
01
—
92691
BLUE CROSS BLUE SHIELD
FL
Enumeration date
10/21/2005
Last updated
08/28/2012
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