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General NPI Number Information
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NPI Number | 1154354389
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Entity Type | Individual
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Provider Name | MUFADDAL GHADIALI MD
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Gender | Male
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 01/02/2009
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Provider Practice Location Address
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Address Line | 6405 N FEDERAL HWY SUITE 402
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-1412
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Country | US
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Telephone | 954-771-8888
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Fax | 954-491-9485
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Provider Business Mailing Address
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Address Line | 6405 N FEDERAL HWY SUITE 402
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-1412
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Country | US
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Telephone | 954-771-8888
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Fax | 954-491-9485
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME94108
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License Number State | FL
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