Provider Demographics
NPI:1811220627
Name:KARDANI, MONA (OD)
Entity Type:Individual
Prefix:DR
First Name:MONA
Middle Name:
Last Name:KARDANI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3307 LITHIA PINECREST RD
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33596-5636
Mailing Address - Country:US
Mailing Address - Phone:813-654-0220
Mailing Address - Fax:813-654-0220
Practice Address - Street 1:3307 LITHIA PINECREST RD
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33596-5636
Practice Address - Country:US
Practice Address - Phone:813-654-0220
Practice Address - Fax:813-654-0220
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-10
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 4497152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist