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General NPI Number Information
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NPI Number | 1407053606
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Entity Type | Organization
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Legal Business Name | CARDONA PAIN & ANESTHESIA
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Dates
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Enumeration Date | 06/29/2007
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Last Update Date | 06/12/2014
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Provider Practice Location Address
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Address Line | 601 UNIVERSITY BLVD SUITE 205
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City | JUPITER
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State | FL
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Zip | 33458-2788
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Country | US
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Telephone | 561-624-0702
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Fax | 561-624-0773
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Provider Business Mailing Address
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Address Line | 1757 SW CABIN PL
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City | PALM CITY
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State | FL
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Zip | 34990-4213
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Country | US
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Telephone | 561-624-0702
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Fax | 561-624-0773
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERTO L DURAN
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Credential | M.D.
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Telephone | 561-624-0702
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | ME84122
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License Number State | FL
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