Provider Demographics
NPI:1588213870
Name:ARMANDO A. PARDILLO, JR., MD, LLC
Entity Type:Organization
Organization Name:ARMANDO A. PARDILLO, JR., MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARMANDO
Authorized Official - Middle Name:A
Authorized Official - Last Name:PARDILLO
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:575-635-7678
Mailing Address - Street 1:3931 DUNESIDE DR
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34949-8511
Mailing Address - Country:US
Mailing Address - Phone:575-635-7678
Mailing Address - Fax:
Practice Address - Street 1:845 37TH PL
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-6564
Practice Address - Country:US
Practice Address - Phone:772-778-0600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-09
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME34986OtherPROFESSIONAL LICENSE