Basic Information
| Provider Information | |||||||||
| NPI: | 1174085153 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GADE | ||||||||
| FirstName: | ANITA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 HOSPITAL PLZ | ||||||||
| Address2: | |||||||||
| City: | STAMFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 069023602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2032767147 | ||||||||
| FaxNumber: | 2032767368 | ||||||||
| Practice Location | |||||||||
| Address1: | 2925 AVENTURA BLVD STE 205 | ||||||||
| Address2: | |||||||||
| City: | AVENTURA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331803108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9544068675 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/01/2019 | ||||||||
| LastUpdateDate: | 05/04/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/04/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 208D00000X | OS17366 | FL | Y | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.