Healthcare Provider Details

I. General information

NPI: 1275941544
Provider Name (Legal Business Name): RIA DINDIAL M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2014
Last Update Date: 07/24/2020
Certification Date: 07/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 SW 62ND AVE
MIAMI FL
33155
US

IV. Provider business mailing address

335 S BISCAYNE BLVD APT 4204
MIAMI FL
33131-2376
US

V. Phone/Fax

Practice location:
  • Phone: 786-624-2891
  • Fax:
Mailing address:
  • Phone: 786-424-3184
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License NumberME131973
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberTRN 19990
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME131973
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: