Provider Demographics
NPI:1033280565
Name:CARDOZO, ERNESTO (MD)
Entity Type:Individual
Prefix:DR
First Name:ERNESTO
Middle Name:
Last Name:CARDOZO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ERNESTO
Other - Middle Name:
Other - Last Name:CARDOZO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10081 PINES BLVD STE E
Mailing Address - Street 2:PINES & PALM OFFICE PARK
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6171
Mailing Address - Country:US
Mailing Address - Phone:954-499-8545
Mailing Address - Fax:954-499-8547
Practice Address - Street 1:10081 PINES BLVD STE E
Practice Address - Street 2:PINES & PALM OFFICE PARK
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6171
Practice Address - Country:US
Practice Address - Phone:954-499-8545
Practice Address - Fax:954-499-8547
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME90704208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME90704OtherMED LICENSE