Individual
CARMELA LYDIA TARDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6271 SAINT AUGUSTINE RD, UFJP DEVELOPMENTAL PEDIATRICS, JACKSONVILLE, FL 32217-2523
(904) 633-0750
Mailing address
PO BOX 44008, UFJP PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
MFC1640
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000692000
—
FL
05
—
1155233
—
LA
05
—
457723146A
—
GA
Enumeration date
07/23/2006
Last updated
02/23/2017
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