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Individual

ELIOT ANDREW BUDNICK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
451 SW BETHANY DR, SUITE #102, PORT ST LUCIE, FL 34986-1964
(772) 202-2734
Mailing address
451 SW BETHANY DR, SUITE #102, PORT ST LUCIE, FL 34986-1964
(772) 202-2734

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
5101015931
MI
2085R0202X
Diagnostic Radiology Physician
OS 10788
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
002276500
FL
Enumeration date
10/29/2008
Last updated
05/30/2013
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