Individual
DR. DAVID WADE REDICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1611 NW 12TH AVE, MIAMI, FL 33136-1005
(305) 326-6391
Mailing address
900 NW 17TH ST, MIAMI, FL 33136-1134
(305) 326-6391
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
LL52722
SC
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LL52722
OPHTHALMOLOGY
SC
Enumeration date
06/29/2018
Last updated
06/06/2019
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