Provider Demographics
NPI:1861021800
Name:BINDERNAGEL, CONSTANCE MELCHIONNA (DO)
Entity Type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:MELCHIONNA
Last Name:BINDERNAGEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:CONSTANCE
Other - Middle Name:ELISE
Other - Last Name:MELCHIONNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17 DAVIS BLVD STE 308
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-3438
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17 DAVIS BLVD STE 308
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-3438
Practice Address - Country:US
Practice Address - Phone:813-974-2201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-02
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program