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NPI Code Detail

MEDICARE: SANDRA LILIANA PEDRAZA CARDOZO M.D.

MEDICARE:   SANDRA LILIANA PEDRAZA CARDOZO  M.D.
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
1207RX0202XMedical Oncology PhysicianD88226MD
2207QH0002XHospice and Palliative Medicine (Family Medicine) PhysicianD88226MD
3207QH0002XHospice and Palliative Medicine (Family Medicine) PhysicianME169606FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
24653868780OTHERMYUTMB 4653868780
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4D88226OTHERMDLICENSE

General Provider Information

NPI Number : 1053502245
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANDRA LILIANA PEDRAZA CARDOZO M.D.
Provider Business Mailing Address
First Line : 2501 N ORANGE AVE STE 235
Second Line :
City : ORLANDO
State : FL
Zip : 32804-4659
Country : US
Telephone Number : 407-303-2906
Fax Number : 407-303-2553
Provider Business Practice Location Address
First Line : 2501 N ORANGE AVE STE 235
Second Line :
City : ORLANDO
State : FL
Zip : 32804-4659
Country : US
Telephone Number : 407-303-2906
Fax Number : 407-303-2553
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2007
Last Update Date : 09/20/2024

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Directions to “ SANDRA LILIANA PEDRAZA CARDOZO M.D.” Practice Location

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