Provider Demographics
NPI:1023079175
Name:RADU, MIHAI (MD)
Entity type:Individual
Prefix:
First Name:MIHAI
Middle Name:
Last Name:RADU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 FORTENBERRY RD
Mailing Address - Street 2:A3
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32952-3601
Mailing Address - Country:US
Mailing Address - Phone:321-453-1717
Mailing Address - Fax:855-816-8510
Practice Address - Street 1:255 FORTENBERRY RD
Practice Address - Street 2:A3
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32952-3601
Practice Address - Country:US
Practice Address - Phone:321-453-1717
Practice Address - Fax:855-816-8510
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0055626208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL063184100Medicaid