Rusi A Udwadia, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

103123-1 Issued in NY

Practice address

4048 Evans Ave
Suite 209
Fort Myers, FL 33901-9385

Phone

(239) 278-9983

Fax

(239) 278-9985

NPI assigned

Jun 14, 2006

Last updated

Aug 4, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pediatric Centers of Lee Co

  • Pediatrics Physician
  • Fort Myers, FL
  • NPI 1205989183
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438646400000",
    "number": "1235172495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4048 EVANS AVE #209",
            "address_2": "# 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019385",
            "telephone_number": "239-278-9983",
            "fax_number": "239-278-9985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4048 EVANS AVE",
            "address_2": "SUITE 209",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019385",
            "telephone_number": "239-278-9983",
            "fax_number": "239-278-9985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDWADIA",
        "first_name": "RUSI",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2015-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "103123-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00686966",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Ann Twitchell, APRN
• Jessica Anne Tyler, APRN
• Nicole Anne Tyrrell, OD
• Joshua Ubbes, DC
• Kathryn Jean Udell, APRN
• Ufirst Surgery Center
• Princess Cynthia Nneamaka Ufoegbune, M.D.
• Jose Mario Ugarriza Mendoza, MD
• Ugo Airport, Inc (Bluebird Mobility, Inc)
• Rita Maria Uguet

• Pediatrics Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.