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General NPI Number Information
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NPI Number | 1942623046
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Entity Type | Organization
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Legal Business Name | MEDICAL ASSOCIATES OF FLORIDA, LLC
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Dates
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Enumeration Date | 01/24/2014
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Last Update Date | 01/24/2014
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Provider Practice Location Address
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Address Line | 2100 LAKE IDA RD STE 1
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City | DELRAY BEACH
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State | FL
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Zip | 33445-2442
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Country | US
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Telephone | 561-303-2766
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Fax | 866-345-7174
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Provider Business Mailing Address
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Address Line | 2100 LAKE IDA RD STE 1
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City | DELRAY BEACH
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State | FL
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Zip | 33445-2442
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Country | US
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Telephone | 561-303-2766
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Fax | 866-345-7174
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALEXANDER FAKADEJ
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Credential | M.D.
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Telephone | 561-265-1116
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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