Healthcare Provider Details

I. General information

NPI: 1700465333
Provider Name (Legal Business Name): VICTORIA CARDIERI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2021
Last Update Date: 06/21/2024
Certification Date: 06/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 2ND ST E
BRADENTON FL
34208-1000
US

IV. Provider business mailing address

22101 MOROSS RD
DETROIT MI
48236-2148
US

V. Phone/Fax

Practice location:
  • Phone: 941-746-5111
  • Fax:
Mailing address:
  • Phone: 313-343-3400
  • Fax: 313-343-4056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME167953
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: