Alla Dudelzak, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME89178 Issued in FL

Practice address

200 NW 7TH Ave
Fort Lauderdale, FL 33311-9026

Phone

(954) 759-6600

Fax

(954) 759-6665

NPI assigned

Jan 25, 2007

Sex

Female

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

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• North Broward Hospital District

  • Neurological Surgery Physician
  • Fort Lauderdale, FL
  • NPI 1801581129
  Medicare reassignment NPD
• North Broward Hospital District

  • Medical Oncology Physician
  • Pompano Beach, FL
  • NPI 1104854157
  NPD
• North Broward Hospital District

  • Community/Retail Pharmacy
  • Pompano Beach, FL
  • NPI 1699709766
  NPD
• Coconut Creek Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Margate, FL
  • NPI 1518232479
  NPD (past)
• FL-I Medical Services, LLC

  • Physician Assistant
  • Margate, FL
  • NPI 1780959643
  NPD (past)
• Nbimc Family Health Center

  • Internal Medicine Physician
  • Newark, NJ
  • NPI 1578521225

  Pediatrics

  NPD (past)
• Newark Beth Israel Medical Center Inc

  • General Acute Care Hospital
  • Newark, NJ
  • NPI 1033210323
  NPD (past)

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1821144973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 NW 49TH ST STE 125",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333093750",
            "telephone_number": "954-759-6600",
            "fax_number": "954-759-6665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NW 7TH AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333119026",
            "telephone_number": "954-759-6600",
            "fax_number": "954-759-6665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDELZAK",
        "first_name": "ALLA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME89178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000820600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Duane Franks Inc
• Astrid M Dublis, M.D.
• Reeve Duboff, ARNP
• Jonathan Duchin, LMHC, EMDR
• Jason Robert Dudas, MD
• Morgan Duffy
• Willene Dufresne Boyce
• Nelson Dufresne, LMT
• Christopher F Duharte
• Shylea Dukat, DO

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.