Healthcare Provider Details

I. General information

NPI: 1033028477
Provider Name (Legal Business Name): ADVANCED TELEMED INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7950 NW 53RD ST STE 337
MIAMI FL
33166-4791
US

IV. Provider business mailing address

7950 NW 53RD ST STE 337
MIAMI FL
33166-4791
US

V. Phone/Fax

Practice location:
  • Phone: 813-433-1105
  • Fax:
Mailing address:
  • Phone: 813-433-1105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. NIRAV DALAL
Title or Position: PRESIDENT
Credential:
Phone: 813-433-1105