Provider Demographics
NPI:1477831709
Name:DINARDO, ANTHONY C (DO)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:C
Last Name:DINARDO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:960 BACK STAGE LN
Mailing Address - Street 2:
Mailing Address - City:LAKE BUENA VISTA
Mailing Address - State:FL
Mailing Address - Zip Code:32830-8472
Mailing Address - Country:US
Mailing Address - Phone:407-934-4100
Mailing Address - Fax:407-934-4101
Practice Address - Street 1:2911 RED BUG LAKE RD
Practice Address - Street 2:
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707-5929
Practice Address - Country:US
Practice Address - Phone:407-699-9511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-03
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS11422207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine