Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | ME69302 | FL |
Y | 111NI0900X | Internist | ME69302 | FL |
N | 207RA0201X | Internist - Allergy & Immunology | ME69302 | FL |
NPI | 1952458101 |
---|---|
Provider Name | Adli Karadsheh |
First Address | Saint Johns, FL 32259-6913 |
Second Address | Saint Johns, FL 32259-6913 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2007 |
Last Update Date | 04/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4301055026 | STATE OF MICHIGAN BOARD OF MEDICINE (01) | MI |
F43981 | (02) | FL |
K0802 | MEDICARE GROUP (01) | FL |
ME69302 | MEDICAL LICENSE NUMBER (01) | FL |