Healthcare Provider Details
I. General information
NPI: 1780678334
Provider Name (Legal Business Name): FRANCIS RAYMUND RIVERO CARANDANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/09/2005
Last Update Date: 08/22/2024
Certification Date: 08/22/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
601 E ROLLINS ST
ORLANDO FL
32803-1248
US
IV. Provider business mailing address
8331 N DAVIS HWY
PENSACOLA FL
32514-6094
US
V. Phone/Fax
- Phone: 407-975-0410
- Fax: 407-975-0411
- Phone: 408-717-3483
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2080P0203X |
| Taxonomy | Pediatric Critical Care Medicine Physician |
| License Number | 024734 |
| License Number State | LA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0203X |
| Taxonomy | Pediatric Critical Care Medicine Physician |
| License Number | ME145223 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: