Provider Demographics
NPI:1295752947
Name:PARDO, STANLEY BENITO (RRT)
Entity type:Individual
Prefix:MR
First Name:STANLEY
Middle Name:BENITO
Last Name:PARDO
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25430 SW 16TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEWBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32669-4907
Mailing Address - Country:US
Mailing Address - Phone:352-472-6633
Mailing Address - Fax:
Practice Address - Street 1:25430 SW 16TH AVE
Practice Address - Street 2:
Practice Address - City:NEWBERRY
Practice Address - State:FL
Practice Address - Zip Code:32669-4907
Practice Address - Country:US
Practice Address - Phone:352-472-6633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT4905227900000X, 2279G1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered
Not Answered2279G1100XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredGeneral Care