Basic Information
| Provider Information | |||||||||
| NPI: | 1568402444 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | LADIA & LADIA MDS PA | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | LILIA DIZON LADIA MD | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 210 NE 19TH DRIVE | ||||||||
| Address2: | |||||||||
| City: | OKEECHOBEE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 349721932 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8637636431 | ||||||||
| FaxNumber: | 8637632319 | ||||||||
| Practice Location | |||||||||
| Address1: | 208 & 210 NE 19TH DRIVE | ||||||||
| Address2: | |||||||||
| City: | OKEECHOBEE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 349721932 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8637636431 | ||||||||
| FaxNumber: | 8637632319 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/07/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | LADIA | ||||||||
| AuthorizedOfficialFirstName: | LILIA | ||||||||
| AuthorizedOfficialMiddleName: | D | ||||||||
| AuthorizedOfficialTitleorPosition: | SECRETARY TREASURER | ||||||||
| AuthorizedOfficialTelephone: | 8637636431 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 0022705 | FL | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.