MEDICARE: LIVIA CORAL GADEA 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
1	207Q00000X	Family Medicine Physician	ME104648	FL
2	207QG0300X	Geriatric Medicine (Family Medicine) Physician	ME104648	FL
3	207QA0505X	Adult Medicine Physician	ME104648	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1639397557
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LIVIA CORAL GADEA MD

Provider Business Mailing Address
First Line	:	5757 COLLINS AVE
Second Line	:	APT .1203
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-2300
Country	:	US
Telephone Number	:	305-903-7646
Fax Number	:

Provider Business Practice Location Address
First Line	:	5757 COLLINS AVE
Second Line	:	APT .1203
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-2300
Country	:	US
Telephone Number	:	305-903-7646
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	09/15/2015

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Directions to “ LIVIA CORAL GADEA MD” Practice Location

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