Provider Demographics
NPI:1366630873
Name:ADONIS PARDO
Entity Type:Organization
Organization Name:ADONIS PARDO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:ADONIS
Authorized Official - Middle Name:
Authorized Official - Last Name:PARDO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:305-962-7341
Mailing Address - Street 1:760 PONCE DE LEON BLVD
Mailing Address - Street 2:SUITE 107A
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2075
Mailing Address - Country:US
Mailing Address - Phone:305-962-7341
Mailing Address - Fax:
Practice Address - Street 1:3059 HIBISCUS ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4340
Practice Address - Country:US
Practice Address - Phone:305-962-7341
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 11446207Q00000X
FLPO3287213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty