Provider Demographics
NPI:1578934121
Name:BADIA, JUAN ARMANDO (MD)
Entity Type:Individual
Prefix:MR
First Name:JUAN
Middle Name:ARMANDO
Last Name:BADIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:13691 METROPOLIS AVE
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-4318
Mailing Address - Country:US
Mailing Address - Phone:239-561-3376
Mailing Address - Fax:239-561-3020
Practice Address - Street 1:687 WILLIAMS AVENUE
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33972
Practice Address - Country:US
Practice Address - Phone:239-561-3376
Practice Address - Fax:239-561-3020
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-08
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME50621207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine