MEDICARE: MAUNA RADAHD MD

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	208100000X	Physical Medicine & Rehabilitation Physician	ME116503	FL
2	208VP0014X	Interventional Pain Medicine Physician	ME116503	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	:	1386806743
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAUNA RADAHD MD

Provider Business Mailing Address
First Line	:	2621 CATTLEMEN RD STE 202
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34232-6212
Country	:	US
Telephone Number	:	941-365-5672
Fax Number	:

Provider Business Practice Location Address
First Line	:	1255 CITY VIEW CTR
Second Line	:
City	:	OVIEDO
State	:	FL
Zip	:	32765-5529
Country	:	US
Telephone Number	:	407-332-1300
Fax Number	:	407-332-4409

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

Provider Enumeration Date	:	06/27/2008
Last Update Date	:	01/19/2021

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