Provider Demographics
NPI:1376865261
Name:ALPENDRE, CRISTIANO VIDOLIN (MD)
Entity Type:Individual
Prefix:DR
First Name:CRISTIANO
Middle Name:VIDOLIN
Last Name:ALPENDRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 MEDICAL OAKS AVE
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5961
Mailing Address - Country:US
Mailing Address - Phone:813-685-7995
Mailing Address - Fax:
Practice Address - Street 1:519 MEDICAL OAKS AVE
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5961
Practice Address - Country:US
Practice Address - Phone:813-685-7995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301092876208600000X
FLME122699208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFA5075874OtherDEA