Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 42997 | AZ |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | 42997 | AZ |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | MD2014-0601 | NM |
NPI | 1205048071 |
---|---|
Provider Name | Dr. Fernando Jose Tondato |
First Address | Albuquerque, NM 87102-2512 |
Second Address | Albuquerque, NM 87102-2512 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2007 |
Last Update Date | 10/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
545699 | (05) | AZ |