Provider Demographics
NPI:1346278116
Name:RUDAS, ROBERT J (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:RUDAS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:MULE CREEK STATE PRISON
Mailing Address - Street 2:4001 HIGHWAY 104
Mailing Address - City:IONE, CA
Mailing Address - State:CA
Mailing Address - Zip Code:95640-3240
Mailing Address - Country:US
Mailing Address - Phone:209-790-9294
Mailing Address - Fax:
Practice Address - Street 1:9280 SW 72ND ST
Practice Address - Street 2:102
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3240
Practice Address - Country:US
Practice Address - Phone:305-275-9525
Practice Address - Fax:305-275-9524
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2024-08-21
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Provider Licenses
StateLicense IDTaxonomies
CAG38302207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLA47434Medicare UPIN