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NPI Code Detail

MEDICARE: JASON L RADICK MD

MEDICARE: JASON L RADICK MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianME82103FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336145440
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASON L RADICK MD
Provider Business Mailing Address
First Line : 4300 ALTON RD, GREEN BLDG
Second Line : STE 810
City : MIAMI BEACH
State : FL
Zip : 33140-2800
Country : US
Telephone Number : 305-674-5925
Fax Number : 305-674-5927
Provider Business Practice Location Address
First Line : 4300 ALTON RD, GREEN BLDG
Second Line : STE 810
City : MIAMI BEACH
State : FL
Zip : 33140-2800
Country : US
Telephone Number : 305-674-5925
Fax Number : 305-674-5927
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2005
Last Update Date : 08/09/2010

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Directions to “ JASON L RADICK MD” Practice Location

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