Munir Ahmed Madiwale, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

ME 22855 Issued in FL

Practice address

5111 SW 113TH Ave
Ft Lauderdale, FL 33330-2826

Phone

(954) 680-4426

Fax

(954) 680-4426

NPI assigned

May 4, 2007

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1588876098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5111 SW 113TH AVE",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333302826",
            "telephone_number": "954-680-4426",
            "fax_number": "954-680-4426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5111 SW 113TH AVE",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333302826",
            "telephone_number": "954-680-4426",
            "fax_number": "954-680-4426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADIWALE",
        "first_name": "MUNIR",
        "middle_name": "AHMED",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-04",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "FL",
            "license": "ME 22855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Child & Adolescent Psychiatry Physician in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Child & Adolescent Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.