Provider Demographics
NPI:1053774877
Name:A VADASZ MD LLC
Entity type:Organization
Organization Name:A VADASZ MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:VADASZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-914-4145
Mailing Address - Street 1:4450 NARRAGANSET TRL
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-1937
Mailing Address - Country:US
Mailing Address - Phone:941-914-4145
Mailing Address - Fax:
Practice Address - Street 1:1219 S EAST AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2340
Practice Address - Country:US
Practice Address - Phone:941-366-5225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-30
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME65805207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty