MEDICARE: IRIT LUDIN-ULLMAN 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	207L00000X	Anesthesiology Physician	ME78484	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ME78484	OTHER	FL	MEDICAL LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497728687
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IRIT LUDIN-ULLMAN MD

Provider Business Mailing Address
First Line	:	1835 NE MIAMI GARDENS DR
Second Line	:	543
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33179-5035
Country	:	US
Telephone Number	:	305-468-4185
Fax Number	:	305-675-3378

Provider Business Practice Location Address
First Line	:	9500 S DADELAND BLVD
Second Line	:	STE 802
City	:	MIAMI
State	:	FL
Zip	:	33156-2824
Country	:	US
Telephone Number	:	305-468-4185
Fax Number	:	305-675-3378

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

Provider Enumeration Date	:	02/09/2006
Last Update Date	:	05/10/2016

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Directions to “ IRIT LUDIN-ULLMAN MD” Practice Location

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