Healthcare Provider Details

I. General information

NPI: 1821066143
Provider Name (Legal Business Name): CECILIA AMAN LADINES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2006
Last Update Date: 03/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6040 STATE ROAD 70 E
BRADENTON FL
34203-9720
US

IV. Provider business mailing address

700 8TH AVE W SUITE 101
PALMETTO FL
34221-4737
US

V. Phone/Fax

Practice location:
  • Phone: 941-366-2273
  • Fax: 941-953-6500
Mailing address:
  • Phone: 941-776-4008
  • Fax: 941-845-4963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME76277
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: