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General NPI Number Information
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NPI Number | 1447523493
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Entity Type | Individual
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Provider Name | PABLO DOLDY CARDONA M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/21/2012
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Last Update Date | 08/11/2014
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Provider Practice Location Address
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Address Line | 26540 ACE AVE STE 108C
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City | LEESBURG
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State | FL
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Zip | 34748-8279
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Country | US
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Telephone | 352-326-5281
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Fax | 352-323-1761
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Provider Business Mailing Address
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Address Line | 1275 NW 122ND ST
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City | NORTH MIAMI
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State | FL
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Zip | 33167-2826
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Country | US
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Telephone | 787-980-8588
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME120187
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License Number State | FL
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