Doctor Name: | MS. AYUMI E CARDOZA |
NPI Number: | 1003001058 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | PA 9104224 |
Business Practice Address: | 91 Branscomb Rd Suite 3 Green Cove Springs, FL - 320437223 |
Business Phone Number: | 9048611034 |
Business Fax Number: | 9048611037 |
Mailing Address: | Po Box 1978, MIDDLEBURG |
State: | FL |
Postal Code: | 320501978 |
Phone Number: | 9042826331 |
Fax Number: | 9042821550 |
NPI Enumeration Date: | 09/12/2007 |
NPI Last Update Date: | 08/19/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA 9104224 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |