Healthcare Provider Details

I. General information

NPI: 1942643317
Provider Name (Legal Business Name): SARADA ALLA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2013
Last Update Date: 07/07/2023
Certification Date: 06/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 W 15TH ST
PLANO TX
75075-7738
US

IV. Provider business mailing address

1525 WEST CYPRESS CREEK ROAD
FORT LAUDERDALE FL
33309
US

V. Phone/Fax

Practice location:
  • Phone: 972-596-6800
  • Fax:
Mailing address:
  • Phone: 954-939-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberME150957
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number312695
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberE-9706
License Number StateAR
# 4
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberS3488
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number4301501857
License Number StateMI
# 6
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number93794
License Number StateGA
# 7
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number66205
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: