Provider Demographics
NPI:1225215064
Name:CHADDA, NADER H (MD)
Entity Type:Individual
Prefix:
First Name:NADER
Middle Name:H
Last Name:CHADDA
Suffix:
Gender:M
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:PO BOX 5368
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34674-5368
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14100 FIVAY RD STE 330
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-7160
Practice Address - Country:US
Practice Address - Phone:727-859-7670
Practice Address - Fax:727-491-5180
Is Sole Proprietor?:No
Enumeration Date:2008-01-23
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1045782086S0129X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001372500Medicaid
FL525541OtherWELLCARE
FL1292562OtherGHI
FLPRO8299OtherQHP - MAIN LOCATION
FL332698OtherAVMED
FLP00900992OtherRAILROAD MCR ATTACHED TO GRP# CH7540
FL145Y0OtherBCBS OF FL
FLPRO8299OtherQHP - SECONDARY LOCATION
FLCD521XMedicare PIN
FL145Y0OtherBCBS OF FL
FL525541OtherWELLCARE