Provider Demographics
NPI:1902337819
Name:BADU, AMA ASANTE
Entity Type:Individual
Prefix:
First Name:AMA ASANTE
Middle Name:
Last Name:BADU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMA ASANTE
Other - Middle Name:
Other - Last Name:BADU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1750 N BAYSHORE DR APT 4315
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33132-3217
Mailing Address - Country:US
Mailing Address - Phone:509-494-3392
Mailing Address - Fax:
Practice Address - Street 1:4302 ALTON RD STE 920
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2890
Practice Address - Country:US
Practice Address - Phone:305-674-2655
Practice Address - Fax:305-674-7668
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-22
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL153954207V00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program