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General NPI Number Information
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NPI Number | 1952458101
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Entity Type | Individual
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Provider Name | ADLI J KARADSHEH M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 6100 MINTON RD NW STE 104
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City | PALM BAY
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State | FL
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Zip | 32907-1900
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Country | US
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Telephone | 321-724-1172
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Fax | 321-984-1695
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Provider Business Mailing Address
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Address Line | 1344 S APOLLO BLVD STE 406
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City | MELBOURNE
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State | FL
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Zip | 32901-3185
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Country | US
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Telephone | 321-253-4032
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Fax | 321-802-5599
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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 | 207RA0201X
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Taxonomy Name | Allergy & Immunology (Internal Medicine) Physician
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License Number | ME69302
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME69302
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License Number State | FL
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