Provider Demographics
NPI:1356319420
Name:D ADRIAN RADULESCU MD PA
Entity Type:Organization
Organization Name:D ADRIAN RADULESCU MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DRAGOS
Authorized Official - Middle Name:ADRIAN
Authorized Official - Last Name:RADULESCU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-696-7900
Mailing Address - Street 1:777 E 25TH STREET
Mailing Address - Street 2:STE 518
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-3825
Mailing Address - Country:US
Mailing Address - Phone:305-696-7900
Mailing Address - Fax:305-696-7131
Practice Address - Street 1:777 E 25TH STREET
Practice Address - Street 2:STE 518
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-3825
Practice Address - Country:US
Practice Address - Phone:305-696-7900
Practice Address - Fax:305-696-7131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-14
Last Update Date:2008-03-18
Deactivation Date:2008-01-30
Deactivation Code:
Reactivation Date:2008-03-18
Provider Licenses
StateLicense IDTaxonomies
FLME73655207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME73655OtherLICENSE