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Individual

ALLISON MUIA WADE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
930 S HARBOR CITY BLVD STE 101, MELBOURNE, FL 32901-1901
(321) 345-7579
(833) 944-2173
Mailing address
930 S HARBOR CITY BLVD STE 101, MELBOURNE, FL 32901-1901
(321) 345-7579
(833) 944-2173

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
ME106167
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
146YK
BCBS
FL
01
CX626Y
MEDICARE
FL
01
KE885
MEDICARE
FL
01
KE886
MEDICARE
FL
01
ME106167
MEDICAL LICENSE
FL
01
MX816
FL MEDICARE
FL
Enumeration date
08/29/2006
Last updated
08/16/2024
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