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General NPI Number Information
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NPI Number | 1073626198
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Entity Type | Individual
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Provider Name | DINA ANTOUN BADRA MD
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Gender | Female
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Dates
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Enumeration Date | 08/15/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 9160 GALLERIA CT
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City | NAPLES
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State | FL
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Zip | 34109-4343
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Country | US
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Telephone | 239-514-8787
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Fax | 239-514-1965
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Provider Business Mailing Address
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Address Line | 15539 MONTEROSSO LN #201
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City | NAPLES
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State | FL
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Zip | 34110-2742
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Country | US
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Telephone | 239-514-8787
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Fax | 239-514-1965
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME0065421
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License Number State | FL
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