Provider Demographics
NPI:1285775130
Name:PARDI, LIVIO FEDERICO (MD)
Entity type:Individual
Prefix:
First Name:LIVIO
Middle Name:FEDERICO
Last Name:PARDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2712 SE COUNTY ROAD 21B
Mailing Address - Street 2:
Mailing Address - City:MELROSE
Mailing Address - State:FL
Mailing Address - Zip Code:32666-5100
Mailing Address - Country:US
Mailing Address - Phone:912-576-6470
Mailing Address - Fax:
Practice Address - Street 1:203 LAKESHORE PT
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:GA
Practice Address - Zip Code:31558-3843
Practice Address - Country:US
Practice Address - Phone:912-576-6465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA 038062207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F80396Medicare UPIN