Provider Demographics
NPI:1194812750
Name:HADEED, PETER ELIAS (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:ELIAS
Last Name:HADEED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8251 W BROWARD BLVD STE 310
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-2703
Mailing Address - Country:US
Mailing Address - Phone:954-587-7577
Mailing Address - Fax:954-587-7199
Practice Address - Street 1:9633 W BROWARD BLVD STE 9
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2332
Practice Address - Country:US
Practice Address - Phone:954-616-5163
Practice Address - Fax:954-587-7199
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME61755208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL25115000Medicaid
FL25115000Medicaid
F46485Medicare UPIN