Healthcare Provider Details

I. General information

NPI: 1801877865
Provider Name (Legal Business Name): MIRCEA OVIDIU BADARA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2005
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 S KANNER HWY FL 3
STUART FL
34994-4801
US

IV. Provider business mailing address

3801 S KANNER HWY FL 3
STUART FL
34994-4801
US

V. Phone/Fax

Practice location:
  • Phone: 772-223-4978
  • Fax: 772-419-2225
Mailing address:
  • Phone: 772-223-4978
  • Fax: 772-419-2225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number179621
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number179621
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number179621
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: