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General NPI Number Information
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NPI Number | 1053527820
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Entity Type | Individual
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Provider Name | VITALIE CRUDU M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 04/29/2022
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Provider Practice Location Address
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Address Line | 9999 NE 2ND AVE STE 215
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City | MIAMI SHORES
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State | FL
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Zip | 33138-2345
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Country | US
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Telephone | 786-652-6781
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Fax | 786-652-6781
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Provider Business Mailing Address
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Address Line | 3201 NE 183RD ST APT 2108
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City | AVENTURA
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State | FL
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Zip | 33160-2896
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Country | US
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Telephone | 786-652-6781
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Fax | 786-652-6781
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME115532
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | ME115532
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | ME115532
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License Number State | FL
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