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Contact Information

FREDERIC L BUSHKIN, MD
3800 JOHNSON ST
SECOND FLOOR, SUITE E
HOLLYWOOD, FL33021-6030
 Phone: 954-985-9336
 Fax: 954-985-9338
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery

208600000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for FREDERIC L BUSHKIN · (Male)

NPI # 1942454210
Status Active
Credentials MD
Entity Individual
Enumeration date 11/12/2008
Last updated 05/03/2017 - About 9 years ago
Sole proprietor 1 No
Identifiers
  • FL License # ME21234
  • FL Medicaid 000562000
  • FL Other 4068300 AETNA
  • FL Other 208599 AVMED
  • FL Other 91698 BCBS
  • FL Other 1666861 CIGNA
  • FL Other 8902 DIMENSION
  • FL Other P1035576 FREEDOM
  • FL Other QMP0000004939254 MOLINA
  • FL Other P971336 OPTIMUM
  • FL Other 961642 WELLCARE
Hospital affiliation(s)
  • MEMORIAL REGIONAL HOSPITAL - (Acute Care)
    3501 JOHNSON ST
    HOLLYWOOD, FL 33021
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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