1356319420 NPI number — D ADRIAN RADULESCU MD PA

Table of content: MS. EYDIE DIANE ARAGON M.S., LMFT (NPI 1720117211)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356319420 NPI number — D ADRIAN RADULESCU MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
D ADRIAN RADULESCU 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:
1356319420
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/18/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
01/30/2008
NPI Reactivation Date:
03/18/2008

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
777 E 25TH STREET
Provider Second Line Business Mailing Address:
STE 518
Provider Business Mailing Address City Name:
HIALEAH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33013-3825
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-696-7900
Provider Business Mailing Address Fax Number:
305-696-7131

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
777 E 25TH STREET
Provider Second Line Business Practice Location Address:
STE 518
Provider Business Practice Location Address City Name:
HIALEAH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33013-3825
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-696-7900
Provider Business Practice Location Address Fax Number:
305-696-7131
Provider Enumeration Date:
03/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
RADULESCU
Authorized Official First Name:
DRAGOS
Authorized Official Middle Name:
ADRIAN
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
305-696-7900

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  ME73655 , 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)

  • Identifier: ME73655 . This is a "LICENSE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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