Provider Demographics
NPI:1972796431
Name:R K KADIYALA MD PL
Entity Type:Organization
Organization Name:R K KADIYALA MD PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGRM
Authorized Official - Prefix:
Authorized Official - First Name:RAJENDRA
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:KADIYALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-695-1290
Mailing Address - Street 1:PO BOX 402866
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-0866
Mailing Address - Country:US
Mailing Address - Phone:305-695-1290
Mailing Address - Fax:305-674-2764
Practice Address - Street 1:4302 ALTON RD
Practice Address - Street 2:SUITE 710
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2891
Practice Address - Country:US
Practice Address - Phone:305-695-1290
Practice Address - Fax:305-674-2764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-19
Last Update Date:2007-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME89940207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG26417Medicare UPIN
FL43279Medicare PIN