Provider Demographics
NPI:1386827590
Name:LAHOUD-BLADYKAS, MAHA (MD)
Entity Type:Individual
Prefix:DR
First Name:MAHA
Middle Name:
Last Name:LAHOUD-BLADYKAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MAHA
Other - Middle Name:
Other - Last Name:LAHOUD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7353 HUNT CLUB LN
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33776-4228
Mailing Address - Country:US
Mailing Address - Phone:727-643-9697
Mailing Address - Fax:
Practice Address - Street 1:10000 BAY PINES BLVD
Practice Address - Street 2:
Practice Address - City:BAY PINES
Practice Address - State:FL
Practice Address - Zip Code:33744-8200
Practice Address - Country:US
Practice Address - Phone:727-398-6661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-11
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01160144472084P0800X
FLME1229042084A0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine