Healthcare Provider Details

I. General information

NPI: 1023011970
Provider Name (Legal Business Name): RALPH G NADER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5555 PONCE DE LEON BLVD
CORAL GABLES FL
33146-2513
US

IV. Provider business mailing address

5555 PONCE DE LEON BLVD
CORAL GABLES FL
33146-2513
US

V. Phone/Fax

Practice location:
  • Phone: 305-585-6683
  • Fax: 305-324-6012
Mailing address:
  • Phone: 305-585-6683
  • Fax: 305-324-6012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME57955
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: