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Contact Information

TAD P DEWALD
3683 S MIAMI AVE STE 460
MIAMI, FL33133-4238
 Phone: 305-459-3377
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Sports Medicine

2081S0010X 25 Physician/Physical Medicine and Rehabilitation
Indicates primary specialty

NPI Profile & details for TAD P DEWALD · (Male)

NPI Number 1811258130
Status Active
Credentials
Entity Individual
Enumeration date 06/04/2012
Last updated 09/05/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • AL License # MD.35418
  • AZ License # 54466
  • FL License # ME162738
  • AZ Medicaid 279012
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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