Dewald, Tad Palmer

Dewald, Tad Palmer is an individual health care provider with primary practice located at 3683 S Miami Ave Ste 460 , Miami FL 33133-4238. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Dewald, Tad Palmer can be contacted via phone (305) 459-3377.

Contact Information

Primary practice address
3683 S Miami Ave Ste 460 Miami FL 33133-4238
Phone: (305) 459-3377
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 2081S0010X MD.35418 Alabama
Allopathic & Osteopathic Physicians / Sports Medicine 2081S0010X 54466 Arizona
Allopathic & Osteopathic Physicians / Sports Medicine 2081S0010X ME162738 Florida

Profile Details

NPI number 1811258130
LBN Legal business name Dewald, Tad Palmer
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 4th, 2012
Last updated Sep 5th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811258130 NPPES
Arizona MEDICAID 279012

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