Provider Demographics
NPI:1508819418
Name:CADUCEAN ADMINISTRATORS INC.
Entity Type:Organization
Organization Name:CADUCEAN ADMINISTRATORS INC.
Other - Org Name:DIRK PARVUS FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DIRK
Authorized Official - Middle Name:F
Authorized Official - Last Name:PARVUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:772-978-9555
Mailing Address - Street 1:PO BOX 6009
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32961-6009
Mailing Address - Country:US
Mailing Address - Phone:772-978-9555
Mailing Address - Fax:772-978-9512
Practice Address - Street 1:1850 37TH ST
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-4856
Practice Address - Country:US
Practice Address - Phone:772-978-9555
Practice Address - Fax:772-978-9512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0066484207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK6555Medicare ID - Type UnspecifiedGROUP NUMBER