Provider Demographics
NPI:1699761973
Name:BADESCU, VLAD (MD)
Entity type:Individual
Prefix:
First Name:VLAD
Middle Name:
Last Name:BADESCU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7050 ULMERTON RD
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-5003
Mailing Address - Country:US
Mailing Address - Phone:727-777-4540
Mailing Address - Fax:727-248-0432
Practice Address - Street 1:7050 ULMERTON RD
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771-5003
Practice Address - Country:US
Practice Address - Phone:727-777-4540
Practice Address - Fax:727-248-0432
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME162048207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL14D0976033OtherCLIA
IL0009932128OtherBC/BS
IL0360916351Medicaid
ILBB4799916OtherDEA
IL209582Medicare ID - Type Unspecified
ILG36109Medicare UPIN
IL0009932128OtherBC/BS