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NPI Code Detail

MEDICARE: PETER CANDELORA MD PA

MEDICARE: PETER CANDELORA MD PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist

General Provider Information

NPI Number : 1023214913
Entity Type Code : Organization
Provider Name (Legal Business Name) : PETER CANDELORA MD PA
Provider Business Mailing Address
First Line : 5604 GULF DR
Second Line :
City : NEW PORT RICHEY
State : FL
Zip : 34652-4020
Country : US
Telephone Number : 727-848-1417
Fax Number : 727-847-7526
Provider Business Practice Location Address
First Line : 5604 GULF DR
Second Line :
City : NEW PORT RICHEY
State : FL
Zip : 34652-4020
Country : US
Telephone Number : 727-848-1417
Fax Number : 727-847-7526
Authorized Official
Title or Position : PRESIDENT
Name : PETER DAVID CANDELORA
Credential : MD
Telephone Number : 727-848-1417
Provider Enumeration Date : 06/26/2007
Last Update Date : 08/22/2020

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