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General NPI Number Information
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NPI Number | 1164558672
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Entity Type | Organization
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Legal Business Name | RAYMOND F HUDANICH MD PA
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6710 W SUNRISE BLVD SUITE 110
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City | PLANTATION
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State | FL
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Zip | 33313-6066
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Country | US
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Telephone | 954-316-1140
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Fax | 954-316-8259
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Provider Business Mailing Address
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Address Line | 6710 W SUNRISE BLVD SUITE 110
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City | PLANTATION
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State | FL
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Zip | 33313-6066
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Country | US
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Telephone | 954-316-1140
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Fax | 954-316-8259
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RAYMOND FRANKLIN HUDANICH
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Credential | MD
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Telephone | 954-316-1140
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | ME13658
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License Number State | FL
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