1083608897 NPI number — RALPH G NADER MD PA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083608897 NPI number — RALPH G NADER MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RALPH G NADER MD PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1083608897
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4302 ALTON RD
Provider Second Line Business Mailing Address:
SUITE 220
Provider Business Mailing Address City Name:
MIAMI BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33140-2891
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-532-6006
Provider Business Mailing Address Fax Number:
305-532-5991

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4302 ALTON RD
Provider Second Line Business Practice Location Address:
SUITE 220
Provider Business Practice Location Address City Name:
MIAMI BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33140-2891
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-532-6006
Provider Business Practice Location Address Fax Number:
305-532-5991
Provider Enumeration Date:
09/07/2005

Additional Information

Authorized Official

Authorized Official Last Name:
NADER
Authorized Official First Name:
RALPH
Authorized Official Middle Name:
GEORGES
Authorized Official Title or Position:
CARDIOLOGIST
Authorized Official Telephone Number:
305-978-0834

Provider Taxonomy Codes

  • Taxonomy code: 207RI0011X , with the licence number:  ME0057955 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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