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Organization
M ANGELA MADDEN LLC
Active
Organization
M ANGELA MADDEN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY A MADDEN MD (DOCTOR)
(954) 563-3158
Entity
Organization
Contact information
Practice address
1130 BAYVIEW DR, FORT LAUDERDALE, FL 33304-2505
(954) 563-3158
(954) 563-5874
Mailing address
1130 BAYVIEW DR, FORT LAUDERDALE, FL 33304-2505
(954) 563-3158
(954) 563-5874
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME79511
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001185
AARP MEDICARE COMPLETE
FL
01
—
0463133
AETNA
FL
01
—
51661
MEDICARE
FL
01
—
CK2070
RAILROAD MEDICARE
GA
01
—
F00219567801
NEIGHBORHOOD HEALTH
—
Enumeration date
07/23/2012
Last updated
08/02/2012
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