Provider Demographics
NPI:1194051011
Name:DADI CARDIAC CARE CENTER INC
Entity type:Organization
Organization Name:DADI CARDIAC CARE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAUL
Authorized Official - Middle Name:S
Authorized Official - Last Name:DADI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:888-407-6166
Mailing Address - Street 1:6735 ROYAL ORCHID CIRCLE
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-4338
Mailing Address - Country:US
Mailing Address - Phone:888-407-6166
Mailing Address - Fax:954-692-3438
Practice Address - Street 1:10301 HAGEN RANCH RD
Practice Address - Street 2:B 550
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3724
Practice Address - Country:US
Practice Address - Phone:888-407-6166
Practice Address - Fax:954-692-3438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-28
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME70810207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF86624Medicare UPIN