Individual
ALLEN R CONDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
730 MALABAR RD STE B, MALABAR, FL 32950-3140
(321) 409-6800
(321) 409-6810
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 312-3470
(321) 951-7408
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME72243
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32596Z
MEDICARE
FL
Enumeration date
10/26/2005
Last updated
11/15/2018
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