Gondor, Magdalen

Gondor, Magdalen is an individual health care provider with primary practice located at 601 5Th St S Suite 708, St Petersburg FL 33701-4804. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Pulmonology, which is considered as her primary health care specialty. Gondor, Magdalen can be contacted via phone (727) 767-8249.

Contact Information

Primary practice address
601 5Th St S Suite 708 St Petersburg FL 33701-4804
Fax: (727) 767-4272
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Pulmonology 2080P0214X ME75740 Florida

Profile Details

NPI number 1467433318
LBN Legal business name Gondor, Magdalen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 8th, 2005
Last updated Aug 18th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467433318 NPPES
Florida MEDICAID 254042800

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