Provider Demographics
NPI:1083880660
Name:TAPNIO, LYSANDRO ORDONEZ (DMD, PA)
Entity Type:Individual
Prefix:MR
First Name:LYSANDRO
Middle Name:ORDONEZ
Last Name:TAPNIO
Suffix:
Gender:M
Credentials:DMD, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9272 ARLINGTON EXPRESSWAY
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32225
Mailing Address - Country:US
Mailing Address - Phone:904-641-0944
Mailing Address - Fax:904-642-2999
Practice Address - Street 1:9272 ARLINGTON EXPRESSWAY
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32225
Practice Address - Country:US
Practice Address - Phone:904-641-0944
Practice Address - Fax:904-642-2999
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-05
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN10175122300000X
FL10175122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist