Healthcare Provider Details

I. General information

NPI: 1942687546
Provider Name (Legal Business Name): JUAN CAMILO RESTREPO CARDENAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2015
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 UNDERWOOD ST
ORLANDO FL
32806-1115
US

IV. Provider business mailing address

52 UNDERWOOD ST
ORLANDO FL
32806-1115
US

V. Phone/Fax

Practice location:
  • Phone: 407-712-8131
  • Fax:
Mailing address:
  • Phone: 407-712-8131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME180022
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number39271
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: