Healthcare Provider Details

I. General information

NPI: 1992875587
Provider Name (Legal Business Name): ANTHONY N DARDANO D O P A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 12/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

951 NW 13TH ST SUITE 4D
BOCA RATON FL
33486-2359
US

IV. Provider business mailing address

951 NW 13TH ST SUITE 4D
BOCA RATON FL
33486-2359
US

V. Phone/Fax

Practice location:
  • Phone: 561-361-0065
  • Fax: 561-347-1945
Mailing address:
  • Phone: 561-361-0065
  • Fax: 561-347-1945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberOS7441
License Number StateFL

VIII. Authorized Official

Name: ANTHONY NICHOLAS DARDANO
Title or Position: PRESIDENT
Credential: D.O.
Phone: 561-361-0065