| Doctor Name: | JESUS RAFAEL PICHARDO |
| NPI Number: | 1922083948 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | ACN320 |
| Business Practice Address: | 1130 S Semoran Blvd Orlando, FL - 328071457 |
| Business Phone Number: | 4073821376 |
| Business Fax Number: | 3212353232 |
| Mailing Address: | 1130 S Semoran Blvd, ORLANDO |
| State: | FL |
| Postal Code: | 328071457 |
| Phone Number: | 4073821376 |
| Fax Number: | 3212353232 |
| NPI Enumeration Date: | 12/13/2005 |
| NPI Last Update Date: | 04/19/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | ACN320 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |