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General NPI Number Information
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NPI Number | 1306203500
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Entity Type | Organization
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Legal Business Name | CDU STAT INC
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Dates
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Enumeration Date | 01/20/2016
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Last Update Date | 01/20/2016
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Provider Practice Location Address
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Address Line | 5000 UNIVERSITY DR
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City | CORAL GABLES
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State | FL
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Zip | 33146-2008
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Country | US
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Telephone | 305-662-9372
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Fax |
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Provider Business Mailing Address
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Address Line | 1643 HARRISON PKWY BUILDING H, SUITE 100
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City | SUNRISE
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State | FL
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Zip | 33323-2857
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Country | US
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Telephone | 954-377-2511
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSEPH J PORTUONDO
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Credential | M.D.
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Telephone | 305-666-6640
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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