Provider Demographics
NPI:1346352911
Name:DADIA, NIREN M (RPH)
Entity Type:Individual
Prefix:MR
First Name:NIREN
Middle Name:M
Last Name:DADIA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 N OCEAN BLVD
Mailing Address - Street 2:APP#704
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-5113
Mailing Address - Country:US
Mailing Address - Phone:954-941-9430
Mailing Address - Fax:954-565-6537
Practice Address - Street 1:2420 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33305-2541
Practice Address - Country:US
Practice Address - Phone:954-565-6496
Practice Address - Fax:954-565-6537
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0037155183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0556050953Medicare ID - Type Unspecified