Individual
DR. LUCAS JEREMY BADER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12550 BISCAYNE BLVD STE 405, NORTH MIAMI, FL 33181-2539
(786) 539-2421
(786) 619-3366
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 434-1401
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
A112030
CA
207X00000X
Orthopaedic Surgery Physician
Primary
ME95823
FL
207XX0801X
Orthopaedic Trauma Physician
ME95823
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02005067
—
MS
05
—
112202500
—
FL
05
—
2432206
—
LA
01
—
OD888
MEDICARE HFMG
FL
01
—
OD890
MEDICARE HFPSI
FL
Enumeration date
05/31/2007
Last updated
06/18/2024
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