Provider Demographics
NPI:1083753909
Name:PARDO, CARLA J (MD)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:J
Last Name:PARDO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1804 WIND RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32003-4704
Mailing Address - Country:US
Mailing Address - Phone:904-592-7563
Mailing Address - Fax:
Practice Address - Street 1:2021 KINGSLEY AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-5174
Practice Address - Country:US
Practice Address - Phone:904-276-5400
Practice Address - Fax:904-276-5430
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME96002207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology