SHAHRAD MABOURAKH MD PA
Osteopathic Medicine at Commercial Blvd, Fort Lauderdale, FL

License number
Florida ME67283
Category
Osteopathic Medicine
Type
Internal Medicine
Owner
Name: DR. SHAHRAD MABOURAKH M.D.
Title: PHYSICIAN
Phone: (954) 746-5803
Address
Address
4600 W Commercial Blvd SUITE 1, Fort Lauderdale, FL 33319
National Provider ID: 1871765727
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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SHAHRAD MABOURAKH, M.D., PA

Fort Lauderdale, FL

Industry:
Nurse Practitioners, Internist
Registration:
Oct 25, 1996
Addresses:
6463 W Commercial Blvd, Fort Lauderdale, FL 33319 (Physical)
4600 W Commercial Blvd, Fort Lauderdale, FL 33319
State ID:
P96000088306
Business type:
Florida Profit Corporation
President, Secretary:
Shahrad Md Mabourakh (President, Secretary), 6463 W Commercial Blvd, Fort Lauderdale, FL 33319 (Physical)
Agent:
Mabourakh, Shahrad,6463 W Commerical Blvd, Fort Lauderdale, FL 33319 (Physical)
EIN:
65-0703258

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