Provider Demographics
NPI:1750310223
Name:CONDON, JOSEPH F (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:F
Last Name:CONDON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:3417 TAMIAMI TRL STE A
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33952-8158
Mailing Address - Country:US
Mailing Address - Phone:941-626-5291
Mailing Address - Fax:877-349-5062
Practice Address - Street 1:3417 TAMIAMI TRL STE A
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-8158
Practice Address - Country:US
Practice Address - Phone:941-344-9249
Practice Address - Fax:941-827-8412
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH17334208100000X
FLME148837208100000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME148837OtherLICENSE
FLME148837OtherLICENSE