Individual
CRAIG J BADOLATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1430 PINE ST, MELBOURNE, FL 32901-3119
(321) 674-5050
(321) 952-6296
Mailing address
PO BOX 534595, ATLANTA, GA 30353-4595
(321) 636-2111
(321) 636-7180
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
ME61815
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03714
WELLCARE
FL
01
—
110067794
RAILROAD MEDICARE
FL
01
—
15118
BLUE CROSS BLUE SHIELD
FL
05
—
373692000
—
FL
01
—
4268178
AETNA
FL
01
—
667172
AETNA
FL
01
—
808490001
CIGNA
FL
Enumeration date
11/08/2005
Last updated
04/26/2019
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