Healthcare Provider Details

I. General information

NPI: 1124225529
Provider Name (Legal Business Name): RICHARD D NADAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2007
Last Update Date: 02/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

580 CRANDON BLVD SUITE 102
KEY BISCAYNE FL
33149-1832
US

IV. Provider business mailing address

51 BAY HEIGHTS DR
MIAMI FL
33133-2631
US

V. Phone/Fax

Practice location:
  • Phone: 305-365-5595
  • Fax:
Mailing address:
  • Phone: 787-507-4422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number010284
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberME 41312
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: