Provider Demographics
NPI:1497728687
Name:LUDIN-ULLMAN, IRIT (MD)
Entity Type:Individual
Prefix:
First Name:IRIT
Middle Name:
Last Name:LUDIN-ULLMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1835 NE MIAMI GARDENS DR
Mailing Address - Street 2:543
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33179-5035
Mailing Address - Country:US
Mailing Address - Phone:305-468-4185
Mailing Address - Fax:305-675-3378
Practice Address - Street 1:9500 S DADELAND BLVD
Practice Address - Street 2:STE 802
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-2824
Practice Address - Country:US
Practice Address - Phone:305-468-4185
Practice Address - Fax:305-675-3378
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME78484207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME78484OtherMEDICAL LICENSE
FL259578800Medicaid
H23722Medicare UPIN
FL35289ZMedicare ID - Type Unspecified