NPIMap

Individual provider Active NPI

Malik Fakhar, MD

  • Neurology Physician
  • Deerfield Beach, FL
National Provider Identifier
1104359058
Registry record updated Oct 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
ME162519 Issued in FL
Practice address
1 W Sample Rd Ste 104
Deerfield Beach, FL 33064-3547
Phone
(954) 786-5151
Fax
(954) 786-2311
NPI assigned
Apr 7, 2017
Last updated
Oct 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X ME162519 FL Primary
Neuroradiology Physician 2085N0700X ME162519 FL

Addresses

Primary practice location

1 W Sample Rd Ste 104
Deerfield Beach, FL 33064-3547

Mailing address

1608 SE 3Rd Ave FL 3
Fort Lauderdale, FL 33316-2564
Phone (954) 786-5151

Other identifiers 1

IdentifierTypeStateIssuer
126343700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230526001595 FL Practitioner - Interventional Radiology 1759748262 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Radiology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Broward Hospital DistrictGroup PAC ID 3577472422, 192 clinicians

Practice addresses (Care Compare)

1 W Sample Rd
Suite 104
Deerfield Beach, FL 33064-3547
Phone (954) 786-5151

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME162519FLMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Broward Hospital District CurrentSince Oct 6, 2025 Accepting new patients
North Broward Hospital District CurrentSince Oct 6, 2025 Accepting new patients
North Broward Hospital District Current Accepting new patients
North Broward Hospital District Past Accepting new patients
Baptist Health Medical Group Oncology LLC PastSince May 1, 2023 Accepting new patients
North Broward Hospital District Past Accepting new patients

Locations

1 W Sample Rd
Ste 104
Deerfield Beach, FL 33064
Phone (954) 341-9771

1600 S Andrews Ave
Ft Lauderdale, FL 33316
Phone (954) 355-4000

1608 SE 3rd Ave
Fl 3
Ft Lauderdale, FL 33316

3540 N Pine Island Rd
Sunrise, FL 33351
Phone (954) 321-1776

Networks

  • Freedom Health HMO Network

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1491523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760659200000",
    "number": "1104359058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 SE 3RD AVE FL 3",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162564",
            "telephone_number": "954-786-5151",
            "fax_number": "954-786-2311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 W SAMPLE RD STE 104",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "330643547",
            "telephone_number": "954-786-5151",
            "fax_number": "954-786-2311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAKHAR",
        "first_name": "MALIK",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-07",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME162519",
            "primary": true
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "FL",
            "license": "ME162519",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126343700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerfield Beach, FL

Sources for this page

Verify at the official NPI Registry.