Provider Demographics
NPI:1871607242
Name:BASKOT, BILJANA (MD)
Entity type:Individual
Prefix:
First Name:BILJANA
Middle Name:
Last Name:BASKOT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1142 E BROWARD BLVD
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-2012
Mailing Address - Country:US
Mailing Address - Phone:954-888-8958
Mailing Address - Fax:954-832-8385
Practice Address - Street 1:1142 E BROWARD BLVD
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301-2012
Practice Address - Country:US
Practice Address - Phone:954-888-8958
Practice Address - Fax:954-832-8385
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME70813207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL250267400Medicaid
FL31392Medicare ID - Type Unspecified
FL250267400Medicaid