Healthcare Provider Details

I. General information

NPI: 1346284155
Provider Name (Legal Business Name): BERNARDO JOSE ORDONEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 01/10/2024
Certification Date: 01/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 MEDICAL PKWY STE 206
CHESAPEAKE VA
23320-4985
US

IV. Provider business mailing address

667 KINGSBOROUGH SQ STE 101
CHESAPEAKE VA
23320-4999
US

V. Phone/Fax

Practice location:
  • Phone: 757-690-8990
  • Fax:
Mailing address:
  • Phone: 757-842-4481
  • Fax: 757-625-0501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number0101057451
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: