Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208G00000X | Cardiothoracic Vascular Surgeon | 51392 | MN |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | ME102689 | FL |
NPI | 1073622585 |
---|---|
Provider Name | Kevin Landolfo |
First Address | Jacksonville, FL 32224-1865 |
Second Address | Jacksonville, FL 32224-1865 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 31/08/2020 |