MEDICARE: FRANCESCO STANDOLI MD, 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
1	261QM2500X	Medical Specialty Clinic/Center	MD 2006-0288	NM

General Provider Information

NPI Number	:	1427387836
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRANCESCO STANDOLI MD, LLC

Provider Business Mailing Address
First Line	:	PO BOX 20357
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87154-0357
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9207 SNOWRIDGE CT NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87111-2440
Country	:	US
Telephone Number	:	505-293-1183
Fax Number	:

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	FRANCESCO STANDOLI
Credential	:	M.D.
Telephone Number	:	505-293-1183

Provider Enumeration Date	:	12/14/2009
Last Update Date	:	02/01/2011

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