MEDICARE: DR. VITALIE CRUDU M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME115532	FL
2	207RC0000X	Cardiovascular Disease Physician	ME115532	FL
3	207RI0011X	Interventional Cardiology Physician	ME115532	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053527820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VITALIE CRUDU M.D.

Provider Business Mailing Address
First Line	:	3201 NE 183RD ST APT 2108
Second Line	:
City	:	AVENTURA
State	:	FL
Zip	:	33160-2896
Country	:	US
Telephone Number	:	786-652-6781
Fax Number	:	786-652-6781

Provider Business Practice Location Address
First Line	:	9999 NE 2ND AVE STE 215
Second Line	:
City	:	MIAMI SHORES
State	:	FL
Zip	:	33138-2345
Country	:	US
Telephone Number	:	786-652-6781
Fax Number	:	786-652-6781

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	04/29/2022

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Directions to “ DR. VITALIE CRUDU M.D.” Practice Location

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