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NPI Code Detail

MEDICARE: ANA CONDE LLC

MEDICARE: ANA CONDE LLC
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
1207RI0200XInfectious Disease Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1023732633
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANA CONDE LLC
Provider Business Mailing Address
First Line : PO BOX 560538
Second Line :
City : ROCKLEDGE
State : FL
Zip : 32956-0538
Country : US
Telephone Number : 321-368-3862
Fax Number :
Provider Business Practice Location Address
First Line : 2428 CLEARLAKE RD BLDG K
Second Line :
City : COCOA
State : FL
Zip : 32922-5722
Country : US
Telephone Number : 321-368-3862
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MR. ANA CONDE
Credential :
Telephone Number : 321-368-3862
Provider Enumeration Date : 09/27/2022
Last Update Date : 05/17/2023

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Directions to “ANA CONDE LLC ” Practice Location

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