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NPI Code Detail

MEDICARE: DR. ALLA DUDELZAK MD

MEDICARE: DR. ALLA DUDELZAK 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
1208000000XPediatrics PhysicianME89178FL

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 : 1821144973
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALLA DUDELZAK MD
Provider Business Mailing Address
First Line : 1700 NW 49TH ST STE 125
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33309-3750
Country : US
Telephone Number : 954-759-6600
Fax Number : 954-759-6665
Provider Business Practice Location Address
First Line : 200 NW 7TH AVE
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33311-9026
Country : US
Telephone Number : 954-759-6600
Fax Number : 954-759-6665
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2007
Last Update Date : 07/26/2022

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Directions to “ DR. ALLA DUDELZAK MD” Practice Location

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