Provider Demographics
NPI:1740266311
Name:PADEH, YORAM CARMI (MD)
Entity type:Individual
Prefix:DR
First Name:YORAM
Middle Name:CARMI
Last Name:PADEH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:7800 S.W. 87TH AVENUE
Mailing Address - Street 2:SUITE C-340
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3570
Mailing Address - Country:US
Mailing Address - Phone:305-595-7091
Mailing Address - Fax:305-595-2836
Practice Address - Street 1:2925 AVENTURA BLVD
Practice Address - Street 2:SUITE 308
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-3124
Practice Address - Country:US
Practice Address - Phone:305-932-5662
Practice Address - Fax:305-932-1011
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME82333207K00000X
NY227893207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME82333OtherFLORIDA MEDICAL LICENSE
FL272449900Medicaid
NY227893OtherNEW YORK MEDICAL LICENSE
NY227893OtherNEW YORK MEDICAL LICENSE
FLI38009Medicare UPIN
FLU5549Medicare ID - Type Unspecified