Provider Demographics
NPI:1992875587
Name:ANTHONY N DARDANO D O P A
Entity type:Organization
Organization Name:ANTHONY N DARDANO D O P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:NICHOLAS
Authorized Official - Last Name:DARDANO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:561-361-0065
Mailing Address - Street 1:951 NW 13TH ST
Mailing Address - Street 2:SUITE 4D
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-2359
Mailing Address - Country:US
Mailing Address - Phone:561-361-0065
Mailing Address - Fax:561-347-1945
Practice Address - Street 1:951 NW 13TH ST
Practice Address - Street 2:SUITE 4D
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-2359
Practice Address - Country:US
Practice Address - Phone:561-361-0065
Practice Address - Fax:561-347-1945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS7441208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAC292Medicare PIN