Healthcare Provider Details

I. General information

NPI: 1710241591
Provider Name (Legal Business Name): KATHRYN JOANNE BONDANI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2012
Last Update Date: 07/16/2024
Certification Date: 01/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

86 W UNDERWOOD ST SUITE 200
ORLANDO FL
32806-1110
US

IV. Provider business mailing address

1049 HOWELL HARBOR DR
CASSELBERRY FL
32707-5810
US

V. Phone/Fax

Practice location:
  • Phone: 407-237-6329
  • Fax: 407-649-3083
Mailing address:
  • Phone: 901-406-8069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberTRN17702
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME122892
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: