Provider Demographics
NPI:1093957201
Name:BORDONI, PAOLA ANDREA (DO)
Entity Type:Individual
Prefix:
First Name:PAOLA
Middle Name:ANDREA
Last Name:BORDONI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9595 N KENDALL DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1979
Mailing Address - Country:US
Mailing Address - Phone:305-279-8222
Mailing Address - Fax:
Practice Address - Street 1:9595 N KENDALL DR
Practice Address - Street 2:SUITE 103
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1979
Practice Address - Country:US
Practice Address - Phone:305-279-8222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-02
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 12035207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HO6302Medicare UPIN