1780876326 NPI number — MS. ALBA PATRICIA CARDONA ARNP

Table of content: MS. ALBA PATRICIA CARDONA ARNP (NPI 1780876326)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780876326 NPI number — MS. ALBA PATRICIA CARDONA ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CARDONA
Provider First Name:
ALBA
Provider Middle Name:
PATRICIA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
ARNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1780876326
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/03/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
207 S. COLLEGE STREET
Provider Second Line Business Mailing Address:
ALBA P CARDONA, ARNP
Provider Business Mailing Address City Name:
LEESBURG
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34748
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
352-326-8115
Provider Business Mailing Address Fax Number:
352-326-5282

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
701 MEDICAL PLAZA DRIVE
Provider Second Line Business Practice Location Address:
TRI COUNTY ORTHOPAEDIC CENTER
Provider Business Practice Location Address City Name:
LEESBURG
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34748
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-326-8115
Provider Business Practice Location Address Fax Number:
352-326-5282
Provider Enumeration Date:
08/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  ARNP2578582 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2578582 . This is a "ARNP" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 108973 . This is a "RURAL MEDICARE GROUP" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 105466400 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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