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NPI Code Detail

MEDICARE: EMILIO CARDONA-ORTIZ M.D.

MEDICARE:   EMILIO  CARDONA-ORTIZ  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
1207Q00000XFamily Medicine Physician4301064038MI

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 : 1265424816
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILIO CARDONA-ORTIZ M.D.
Provider Business Mailing Address
First Line : 27774 FRANKLIN RD
Second Line :
City : SOUTHFIELD
State : MI
Zip : 48034-2352
Country : US
Telephone Number : 248-356-5555
Fax Number : 248-356-5544
Provider Business Practice Location Address
First Line : 10248 W JEFFERSON AVE
Second Line :
City : RIVER ROUGE
State : MI
Zip : 48218-1321
Country : US
Telephone Number : 313-841-7575
Fax Number : 313-841-1713
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2005
Last Update Date : 05/29/2014

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Directions to “ EMILIO CARDONA-ORTIZ M.D.” Practice Location

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