Provider Demographics
NPI:1588818728
Name:TAL T ROUDNER MD PA
Entity Type:Organization
Organization Name:TAL T ROUDNER MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TAL
Authorized Official - Middle Name:T
Authorized Official - Last Name:ROUDNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305443-443-3531
Mailing Address - Street 1:550 BILTMORE WAY
Mailing Address - Street 2:SUITE 890
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-5730
Mailing Address - Country:US
Mailing Address - Phone:305-443-3531
Mailing Address - Fax:305-567-1519
Practice Address - Street 1:550 BILTMORE WAY
Practice Address - Street 2:SUITE 890
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5730
Practice Address - Country:US
Practice Address - Phone:305-443-3531
Practice Address - Fax:305-567-1519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-14
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty