Provider Demographics
NPI:1952458101
Name:KARADSHEH, ADLI (MD)
Entity Type:Individual
Prefix:
First Name:ADLI
Middle Name:
Last Name:KARADSHEH
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 1:27334 BONTERRA LOOP APT 202
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-5141
Mailing Address - Country:US
Mailing Address - Phone:904-525-9655
Mailing Address - Fax:
Practice Address - Street 1:7562 W GULF TO LAKE HWY
Practice Address - Street 2:
Practice Address - City:CRYSTAL RIVER
Practice Address - State:FL
Practice Address - Zip Code:34429-7840
Practice Address - Country:US
Practice Address - Phone:352-436-4328
Practice Address - Fax:352-436-0900
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME69302207R00000X, 207RA0201X, 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
FLME69302OtherMEDICAL LICENSE NUMBER
FLK0802OtherMEDICARE GROUP
MI4301055026OtherSTATE OF MICHIGAN BOARD OF MEDICINE
FLME69302OtherMEDICAL LICENSE NUMBER