Healthcare Provider Details

I. General information

NPI: 1659339471
Provider Name (Legal Business Name): ADOLFO A. ALDAPE, M.D.P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4070 N CHINOOK LN
ORMOND BEACH FL
32174-9325
US

IV. Provider business mailing address

4070 N CHINOOK LN
ORMOND BEACH FL
32174-9325
US

V. Phone/Fax

Practice location:
  • Phone: 956-337-9023
  • Fax:
Mailing address:
  • Phone: 956-337-9023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberK9971
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberK9971
License Number StateTX

VIII. Authorized Official

Name: DR. ADOLFO ALEJANDRO ALDAPE
Title or Position: OWNER
Credential: MD
Phone: 956-337-9023