MEDICARE: MARCELA FANDINO CARDENAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207YP0228X	Pediatric Otolaryngology Physician	NA	MN

General Provider Information

NPI Number	:	1306772728
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCELA FANDINO CARDENAS

Provider Business Mailing Address
First Line	:	420 DELAWARE ST SE MMC 396
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55455
Country	:	US
Telephone Number	:	612-625-9996
Fax Number	:	612-625-2101

Provider Business Practice Location Address
First Line	:	516 DELAWARE ST SE MMC 396
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55455
Country	:	US
Telephone Number	:	612-625-9996
Fax Number	:	612-625-2101

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2026
Last Update Date	:	06/23/2026

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