Healthcare Provider Details

I. General information

NPI: 1003026055
Provider Name (Legal Business Name): RADHIKA PUSHKAR PHADKE M.D, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E SAMPLE RD STE 200
POMPANO BEACH FL
33064-3554
US

IV. Provider business mailing address

1608 SE 3RD AVE FL 3
FORT LAUDERDALE FL
33316-2564
US

V. Phone/Fax

Practice location:
  • Phone: 954-481-9184
  • Fax: 954-481-9317
Mailing address:
  • Phone: 954-481-9184
  • Fax: 954-481-9317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberME129568
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: