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General NPI Number Information
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NPI Number | 1558161414
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Entity Type | Organization
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Legal Business Name | MD GENETIC LLC
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Dates
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Enumeration Date | 03/18/2025
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Last Update Date | 07/03/2025
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Provider Practice Location Address
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Address Line | 1201 6TH AVE W STE 100-668
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City | BRADENTON
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State | FL
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Zip | 34205-7400
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Country | US
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Telephone | 941-202-2260
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Fax | 941-279-3154
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Provider Business Mailing Address
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Address Line | 1943 PLEASANT MAPLE CT
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City | BRADENTON
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State | FL
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Zip | 34211-0528
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Country | US
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Telephone | 317-701-3613
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Fax | 941-279-3154
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Authorized Official
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Title or Position | PHYSICIAN/ MEDICAL GENETICIST
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Name | DR. NADIA A FALAH
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Credential | MD
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Telephone | 317-701-3613
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207SG0207X
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Taxonomy Name | Medical Biochemical Genetics
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License Number |
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License Number State |
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