Healthcare Provider Details

I. General information

NPI: 1861021800
Provider Name (Legal Business Name): CONSTANCE MELCHIONNA BINDERNAGEL DO, MBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CONSTANCE ELISE MELCHIONNA DO

II. Dates (important events)

Enumeration Date: 04/02/2020
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5959 17TH AVE W
BRADENTON FL
34209-7836
US

IV. Provider business mailing address

5959 17TH AVE W
BRADENTON FL
34209-7836
US

V. Phone/Fax

Practice location:
  • Phone: 941-877-2687
  • Fax: 941-340-0794
Mailing address:
  • Phone: 941-877-2687
  • Fax: 941-340-0794

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberOS19953
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2080P0201X
TaxonomyPediatric Allergy/Immunology Physician
License NumberOS19953
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: