Provider Demographics
NPI:1619134319
Name:DR. JOSEPH CHRISTIAN HADEED
Entity Type:Organization
Organization Name:DR. JOSEPH CHRISTIAN HADEED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-656-8855
Mailing Address - Street 1:2929 N UNIVERSITY DR STE 110
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-5047
Mailing Address - Country:US
Mailing Address - Phone:954-656-8855
Mailing Address - Fax:
Practice Address - Street 1:9750 NW 33RD ST STE 216
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4081
Practice Address - Country:US
Practice Address - Phone:954-755-5504
Practice Address - Fax:954-755-7052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0056238207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK0890Medicare PIN
FLF07019Medicare UPIN