Healthcare Provider Details

I. General information

NPI: 1861903221
Provider Name (Legal Business Name): ASAF KEDAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2017
Last Update Date: 10/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 NW 10TH AVE
MIAMI FL
33136-1018
US

IV. Provider business mailing address

888 S DOUGLAS RD APT 504
CORAL GABLES FL
33134-7566
US

V. Phone/Fax

Practice location:
  • Phone: 305-585-1152
  • Fax:
Mailing address:
  • Phone: 305-338-3969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number25787
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: