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General NPI Number Information
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NPI Number | 1124072194
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Entity Type | Individual
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Provider Name | ILAN ALHADEFF MD
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Gender | Male
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Dates
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Enumeration Date | 05/22/2006
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Last Update Date | 03/26/2021
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Provider Practice Location Address
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Address Line | 3501 JOHNSON ST
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City | HOLLYWOOD
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State | FL
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Zip | 33021-5421
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Country | US
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Telephone | 954-265-1562
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Fax |
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Provider Business Mailing Address
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Address Line | 1643 NW 136TH AVE STE 100
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City | SUNRISE
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State | FL
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Zip | 33323-2857
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Country | US
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Telephone | 800-424-3672
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Fax | 954-377-3042
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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 | 35.134852
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MA07934400
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 236677
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 51663
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License Number State | TN
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME104650
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License Number State | FL
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