Organization
NATALIA SUDAKOV, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NATALIA SUDAKOV M.D. (CEO)
(954) 391-7864
Entity
Organization
Contact information
Practice address
1801 S OCEAN DR, SUITE E, HALLANDALE BEACH, FL 33009-4945
(954) 391-7864
(954) 391-8468
Mailing address
1801 S OCEAN DR, SUITE E, HALLANDALE BEACH, FL 33009-4945
(954) 391-7864
(954) 391-8468
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
ME85624
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9K9711
MEDICARE ID-TYPE UNSPECIFIED
NY
Enumeration date
07/23/2009
Last updated
07/23/2009
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