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NPI Code Detail

MEDICARE: DR. DALIBOR IRWING HRADEK M.D.

MEDICARE: DR. DALIBOR IRWING HRADEK M.D.
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
1174400000XSpecialist35062245OH
2207V00000XObstetrics & Gynecology PhysicianME98647FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
104862OTHERFLBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1932101169
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DALIBOR IRWING HRADEK M.D.
Provider Business Mailing Address
First Line : PO BOX 499
Second Line :
City : PARRISH
State : FL
Zip : 34219-0499
Country : US
Telephone Number : 941-708-7669
Fax Number : 941-708-8893
Provider Business Practice Location Address
First Line : 1312 MANATEE AVE E
Second Line :
City : BRADENTON
State : FL
Zip : 34208-1358
Country : US
Telephone Number : 941-708-7669
Fax Number : 941-708-8893
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2005
Last Update Date : 01/22/2013

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