Healthcare Provider Details

I. General information

NPI: 1427387836
Provider Name (Legal Business Name): FRANCESCO STANDOLI MD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2009
Last Update Date: 02/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9207 SNOWRIDGE CT NE
ALBUQUERQUE NM
87111-2440
US

IV. Provider business mailing address

PO BOX 20357
ALBUQUERQUE NM
87154-0357
US

V. Phone/Fax

Practice location:
  • Phone: 505-293-1183
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberMD 2006-0288
License Number StateNM

VIII. Authorized Official

Name: FRANCESCO STANDOLI
Title or Position: AUTHORIZED OFFICIAL
Credential: M.D.
Phone: 505-293-1183