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General NPI Number Information
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NPI Number | 1982800819
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Entity Type | Individual
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Provider Name | JAIME E CANDELORI MD
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Gender | Female
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Dates
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Enumeration Date | 06/26/2007
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Last Update Date | 05/27/2021
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Provider Practice Location Address
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Address Line | 101 N COUNTRY CLUB RD STE 113
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City | LAKE MARY
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State | FL
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Zip | 32746-3249
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Country | US
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Telephone | 407-831-6200
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Fax | 407-831-1068
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Provider Business Mailing Address
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Address Line | 900 S PINE ISLAND RD STE 800
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City | PLANTATION
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State | FL
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Zip | 33324-3923
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Country | US
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Telephone | 407-831-6200
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME99161
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License Number State | FL
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