Individual
TIMOTHY MARK CANDELARIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1631 HOSPITAL DR, SANTA FE, NM 87505-4728
(505) 323-7200
(505) 323-7206
Mailing address
1631 HOSPITAL DR, SANTA FE, NM 87505-4728
(505) 983-3275
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R53366
NM
Other
Enumeration date
06/04/2013
Last updated
06/04/2013
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