Provider Demographics
NPI:1053527820
Name:CRUDU, VITALIE (MD)
Entity type:Individual
Prefix:DR
First Name:VITALIE
Middle Name:
Last Name:CRUDU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 NE 183RD ST APT 2108
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33160-2896
Mailing Address - Country:US
Mailing Address - Phone:786-652-6781
Mailing Address - Fax:786-652-6781
Practice Address - Street 1:9999 NE 2ND AVE STE 215
Practice Address - Street 2:
Practice Address - City:MIAMI SHORES
Practice Address - State:FL
Practice Address - Zip Code:33138-2345
Practice Address - Country:US
Practice Address - Phone:786-652-6781
Practice Address - Fax:786-652-6781
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME115532207R00000X, 207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease