Provider Demographics
NPI:1952458101
Name:KARADSHEH, ADLI J (MD)
Entity type:Individual
Prefix:
First Name:ADLI
Middle Name:J
Last Name:KARADSHEH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1344 S APOLLO BLVD STE 406
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-3185
Mailing Address - Country:US
Mailing Address - Phone:321-253-4032
Mailing Address - Fax:321-802-5599
Practice Address - Street 1:6100 MINTON RD NW STE 104
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32907-1900
Practice Address - Country:US
Practice Address - Phone:321-724-1172
Practice Address - Fax:321-984-1695
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2024-11-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME69302207RA0201X, 207R00000X, 207R00000X, 207RA0201X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL122490300Medicaid
FLME69302OtherMEDICAL LICENSE NUMBER
FLK0802OtherMEDICARE GROUP
MI4301055026OtherSTATE OF MICHIGAN BOARD OF MEDICINE