Active NPI
Brian David Udell, M.D.
- Pediatrics Physician
- Davie, FL
National Provider Identifier
1073779724
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME 42264
- Practice address
- 6974 Griffin Rd
Davie, FL 33314-4345 - Phone
- (954) 873-8413
- Fax
- (954) 792-2424
- NPI assigned
- Aug 1, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME 42264 | FL | Primary |
Addresses
Primary practice location
6974 Griffin Rd
Davie, FL 33314-4345
Mailing address
6974 Griffin Rd
Davie, FL 33314-4345
Phone (954) 873-8413
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME 42264 | FL | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621382400000",
"number": "1073779724",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6974 GRIFFIN RD",
"city": "DAVIE",
"state": "FL",
"postal_code": "333144345",
"telephone_number": "954-873-8413",
"fax_number": "954-792-2424"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6974 GRIFFIN RD",
"city": "DAVIE",
"state": "FL",
"postal_code": "333144345",
"telephone_number": "954-873-8413",
"fax_number": "954-792-2424"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UDELL",
"first_name": "BRIAN",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-08-01",
"last_updated": "2021-05-19",
"certification_date": "2021-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME 42264",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Davie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.