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General NPI Number Information
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NPI Number | 1275868846
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Entity Type | Individual
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Provider Name | FRANCISCO A GONDIM M.D., M.SC., PH.D.
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Gender | Male
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Dates
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Enumeration Date | 10/14/2009
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Last Update Date | 10/14/2009
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Provider Practice Location Address
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Address Line | AVENIDA RUI BARBOSA, 748 AP 1100
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City | FORTALEZA
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State | CEARA
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Zip | 60115220
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Country | BR
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Telephone | 011558532243974
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Fax | 011558533668333
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Provider Business Mailing Address
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Address Line | 1438 S GRAND BLVD DEPARTMENT OF NEUROLOGY & PSYCHIATRY
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City | SAINT LOUIS
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State | MO
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Zip | 63104-1027
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Country | US
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Telephone | 314-977-4849
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Fax | 314-977-4876
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | MO2002003281
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License Number State | MO
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