MEDICARE: DR. ILAN RZADKOWOLSKY-RAOLI 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	2085R0204X	Vascular & Interventional Radiology Physician	ME110623	FL
2	2085R0202X	Diagnostic Radiology Physician	ME110623	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	:	1144416975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ILAN RZADKOWOLSKY-RAOLI M.D.

Provider Business Mailing Address
First Line	:	2831 SOUTH BAYSHORE DRIVE
Second Line	:	UNIT 601
City	:	MIAMI
State	:	FL
Zip	:	33133
Country	:	US
Telephone Number	:	718-736-5217
Fax Number	:

Provider Business Practice Location Address
First Line	:	2001 W 68TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33016-1898
Country	:	US
Telephone Number	:	305-823-5000
Fax Number	:

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

Provider Enumeration Date	:	09/14/2007
Last Update Date	:	02/05/2026

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