Provider Demographics
NPI:1023074911
Name:BADA, ALVARO RAMON (MD)
Entity type:Individual
Prefix:
First Name:ALVARO
Middle Name:RAMON
Last Name:BADA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:18308 MURDOCK CIRCLE
Mailing Address - Street 2:#101
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33948
Mailing Address - Country:US
Mailing Address - Phone:941-255-0069
Mailing Address - Fax:941-255-0072
Practice Address - Street 1:18308 MURDOCK CIRCLE
Practice Address - Street 2:#101
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33948
Practice Address - Country:US
Practice Address - Phone:941-255-0069
Practice Address - Fax:941-255-0072
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2018-01-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME39970208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL043820100Medicaid
FLD85614Medicare UPIN
FLD85614Medicare UPIN