Organization
DERMATOLOGY SPECIALISTS OF LAREDO PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NEDIL ALDARONDO-ANTONINI MD (PHYSICIAN)
(956) 729-7700
Entity
Organization
Contact information
Practice address
2344 LAGUNA DEL MAR COURT, SUITE 101, LAREDO, TX 78045
(956) 729-7700
(956) 729-7779
Mailing address
PO BOX 452409, LAREDO, TX 78045
(956) 729-7700
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
K9972
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8H9860
BC BS
—
01
—
P00116091
MEDICARE RAIL ROAD
TX
Enumeration date
09/20/2006
Last updated
12/05/2007
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