Individual
FREDERIC L BUSHKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3800 JOHNSON ST, SECOND FLOOR, SUITE E, HOLLYWOOD, FL 33021-6030
(954) 985-9336
(954) 985-9338
Mailing address
2234 COLONIAL BLVD, ATTN: PAYER CONTRACTING & RELATIONS DEPT., FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME21234
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000562000
—
FL
01
—
1666861
CIGNA
FL
01
—
208599
AVMED
FL
01
—
4068300
AETNA
FL
01
—
8902
DIMENSION
FL
01
—
91698
BCBS
FL
01
—
961642
WELLCARE
FL
01
—
P1035576
FREEDOM
FL
01
—
P971336
OPTIMUM
FL
01
—
QMP0000004939254
MOLINA
FL
Enumeration date
11/12/2008
Last updated
05/03/2017
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