Healthcare Provider Details

I. General information

NPI: 1104921550
Provider Name (Legal Business Name): ISIDRO ANTHONY CARDELLA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 SW 93RD AVE SUITE 200
MIAMI FL
33173-5200
US

IV. Provider business mailing address

7300 SW 93RD AVE SUITE 200
MIAMI FL
33173
US

V. Phone/Fax

Practice location:
  • Phone: 305-971-0510
  • Fax: 305-663-5929
Mailing address:
  • Phone: 305-971-0510
  • Fax: 305-663-5929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberME0056177
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: