Individual
ELAINE S CONDONO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
5538 VINTAGE VIEW PASS, LAKELAND, FL 33812-4061
(301) 653-9169
Mailing address
5538 VINTAGE VIEW PASS, LAKELAND, FL 33812-4061
(301) 653-9169
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
OS11752
FL
207Q00000X
Family Medicine Physician
Primary
02095
WV
207Q00000X
Family Medicine Physician
OS11752
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810011078
—
WV
Enumeration date
08/23/2006
Last updated
10/25/2013
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