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General NPI Number Information
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NPI Number | 1093763690
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Entity Type | Individual
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Provider Name | OMAR CARDENAS M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/05/2006
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Last Update Date | 01/30/2023
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Provider Practice Location Address
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Address Line | 2101 CURRY ROAD LUTZ
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City | LUTZ
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State | FL
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Zip | 33549-3716
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Country | US
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Telephone | 813-901-2704
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Fax | 813-964-3113
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Provider Business Mailing Address
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Address Line | 2101 CURRY RD
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City | LUTZ
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State | FL
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Zip | 33549-3716
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Country | US
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Telephone | 813-501-7407
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Fax | 813-964-3113
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME0076006
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME76006
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License Number State | FL
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