Provider Demographics
NPI:1053344820
Name:LEFKOF, IRA R (MD)
Entity type:Individual
Prefix:MR
First Name:IRA
Middle Name:R
Last Name:LEFKOF
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3700 WASHINGTON ST
Mailing Address - Street 2:#402
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-8249
Mailing Address - Country:US
Mailing Address - Phone:954-966-6630
Mailing Address - Fax:954-966-6102
Practice Address - Street 1:3700 WASHINGTON ST
Practice Address - Street 2:402
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-8249
Practice Address - Country:US
Practice Address - Phone:954-966-6630
Practice Address - Fax:954-966-6102
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2018-07-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME0035862207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL370321500Medicaid
FL370321500Medicaid
D63143Medicare UPIN