Provider Demographics
NPI:1619006574
Name:DR MOSES O ALADE MD PA
Entity Type:Organization
Organization Name:DR MOSES O ALADE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MOSES
Authorized Official - Middle Name:O
Authorized Official - Last Name:ALADE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-651-6755
Mailing Address - Street 1:838 NW 183RD ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-4203
Mailing Address - Country:US
Mailing Address - Phone:305-651-6755
Mailing Address - Fax:305-651-6757
Practice Address - Street 1:838 NW 183RD ST
Practice Address - Street 2:SUITE 102
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33169-4203
Practice Address - Country:US
Practice Address - Phone:305-651-6755
Practice Address - Fax:305-651-6757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME86286207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAE426OtherMEDICARE
FL265919100Medicaid
FLAE426OtherMEDICARE