Provider Demographics
NPI:1932422433
Name:BANAL, RODEL UMLAS (MD)
Entity Type:Individual
Prefix:DR
First Name:RODEL
Middle Name:UMLAS
Last Name:BANAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1314 OAK ST
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-3111
Mailing Address - Country:US
Mailing Address - Phone:321-727-7992
Mailing Address - Fax:321-727-7664
Practice Address - Street 1:1314 OAK ST
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-3111
Practice Address - Country:US
Practice Address - Phone:321-727-7992
Practice Address - Fax:321-727-7664
Is Sole Proprietor?:No
Enumeration Date:2010-03-11
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME115712207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009225100Medicaid
FLP01250539OtherRAILROAD MDCR
FLHN178ZMedicare Oscar/Certification