Provider Demographics
NPI:1255376661
Name:WADDAH ALLAF MD PA
Entity type:Organization
Organization Name:WADDAH ALLAF MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WADDAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLAF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-949-6003
Mailing Address - Street 1:660 CARROTWOOD TER
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-8240
Mailing Address - Country:US
Mailing Address - Phone:305-949-6003
Mailing Address - Fax:305-947-2713
Practice Address - Street 1:20200 W DIXIE HWY STE 1108
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33180-1922
Practice Address - Country:US
Practice Address - Phone:305-949-6003
Practice Address - Fax:305-945-2483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL255021100Medicaid
FL255021100Medicaid
FL6485200Medicare PIN