Healthcare Provider Details

I. General information

NPI: 1124011309
Provider Name (Legal Business Name): RHEUMATOLOGY CONSULTANTS OF DE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2005
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20268 PLANTATIONS RD
LEWES DE
19958-4622
US

IV. Provider business mailing address

PO BOX 37
LEWES DE
19958-0037
US

V. Phone/Fax

Practice location:
  • Phone: 302-644-2633
  • Fax: 302-644-9192
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSE ANTONIO PANDO
Title or Position: PRESIDENT
Credential: MD
Phone: 302-644-2633