Provider Demographics
NPI:1285722686
Name:SZADY, ANITA DOMINIQUE (MD)
Entity type:Individual
Prefix:DR
First Name:ANITA
Middle Name:DOMINIQUE
Last Name:SZADY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 BON AIR RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LARKSPUR
Mailing Address - State:CA
Mailing Address - Zip Code:94939-1144
Mailing Address - Country:US
Mailing Address - Phone:415-927-0666
Mailing Address - Fax:415-927-6159
Practice Address - Street 1:2 BON AIR RD STE 100
Practice Address - Street 2:
Practice Address - City:LARKSPUR
Practice Address - State:CA
Practice Address - Zip Code:94939-1144
Practice Address - Country:US
Practice Address - Phone:415-927-0666
Practice Address - Fax:415-927-6159
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC151690207RA0001X
FLTRN7934207R00000X
FLME109429207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Yes207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC151690OtherMEDICAL BOARD LICENSE
FLFA149ZMedicare PIN
FL003545000Medicaid