Basic Information
| Provider Information | |||||||||
| NPI: | 1568851707 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MD4ER LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1111 12TH ST | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | KEY WEST | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330404088 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3052953535 | ||||||||
| FaxNumber: | 3052946868 | ||||||||
| Practice Location | |||||||||
| Address1: | 5900 COLLEGE RD | ||||||||
| Address2: | |||||||||
| City: | KEY WEST | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330404342 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3052945531 | ||||||||
| FaxNumber: | 3052925837 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/12/2015 | ||||||||
| LastUpdateDate: | 05/28/2015 | ||||||||
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| AuthorizedOfficialLastName: | ATILLA | ||||||||
| AuthorizedOfficialFirstName: | MEHMET | ||||||||
| AuthorizedOfficialMiddleName: | AYDIN | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT/OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3052953535 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207PE0004X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine | Emergency Medical Services |
No ID Information.