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General NPI Number Information
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NPI Number | 1821034828
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Entity Type | Individual
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Provider Name | STEPHANIE ANN CARADONNA M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2179 S TAMIAMI TRL SUITE 101
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City | OSPREY
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State | FL
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Zip | 34229-9239
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Country | US
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Telephone | 941-966-0222
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Fax | 941-966-5100
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Provider Business Mailing Address
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Address Line | 628 CRANE PRAIRIE WAY
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City | OSPREY
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State | FL
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Zip | 34229-7812
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Country | US
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Telephone | 941-966-2310
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | ME87302
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License Number State | FL
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