Basic Information
Provider Information
NPI: 1225042526
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BEKHIT
FirstName: EVON
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9960 CENTRAL PARK BLVD N
Address2: SUITE 450
City: BOCA RATON
State: FL
PostalCode: 334281759
CountryCode: US
TelephoneNumber: 5613531225
FaxNumber: 5613531226
Practice Location
Address1: 4201 N STATE ROAD 7
Address2:  
City: LAUDERDALE LAKES
State: FL
PostalCode: 333194844
CountryCode: US
TelephoneNumber: 9544851311
FaxNumber: 9544851346
Other Information
ProviderEnumerationDate: 07/29/2006
LastUpdateDate: 03/22/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208D00000XME89766FLY Allopathic & Osteopathic PhysiciansGeneral Practice 

No ID Information.


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