Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | ME70566 | FL |
NPI | 1396717575 |
---|---|
Provider Name | Richard Joseph Cardosi |
First Address | Lakeland, FL 33805-3065 |
Second Address | Lakeland, FL 33805-3109 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2006 |
Last Update Date | 22/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G84417 | (02) |