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General NPI Number Information
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NPI Number | 1932101169
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Entity Type | Individual
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Provider Name | DALIBOR IRWING HRADEK M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/01/2005
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Last Update Date | 01/22/2013
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Provider Practice Location Address
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Address Line | 1312 MANATEE AVE E
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City | BRADENTON
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State | FL
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Zip | 34208-1358
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Country | US
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Telephone | 941-708-7669
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Fax | 941-708-8893
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Provider Business Mailing Address
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Address Line | PO BOX 499
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City | PARRISH
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State | FL
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Zip | 34219-0499
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Country | US
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Telephone | 941-708-7669
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Fax | 941-708-8893
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 35062245
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | ME98647
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License Number State | FL
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