Healthcare Provider Details
I. General information
NPI: 1780040980
Provider Name (Legal Business Name): EUFEMIA G CANDO M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/05/2016
Last Update Date: 05/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1490 NW 27TH AVE STE 130
MIAMI FL
33125-2173
US
IV. Provider business mailing address
6100 BLUE LAGOON DR STE 365
MIAMI FL
33126-7010
US
V. Phone/Fax
- Phone: 305-635-7710
- Fax: 786-621-7817
- Phone: 786-322-7333
- Fax: 786-322-7329
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | 019181 |
| License Number State | PR |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | ACN892 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: