Healthcare Provider Details

I. General information

NPI: 1164865861
Provider Name (Legal Business Name): NATALE ROTONDI RDCS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2013
Last Update Date: 04/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20900 BISCAYNE BLVD
AVENTURA FL
33180-1407
US

IV. Provider business mailing address

4748 SW 39TH WAY
FORT LAUDERDALE FL
33312-5446
US

V. Phone/Fax

Practice location:
  • Phone: 561-703-4107
  • Fax:
Mailing address:
  • Phone: 561-703-4107
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246XS1301X
TaxonomySonography Specialist/Technologist Cardiovascular
License Number148340
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: