Basic Information
| Provider Information | |||||||||
| NPI: | 1275868846 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GONDIM | ||||||||
| FirstName: | FRANCISCO | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D., M.SC., PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1438 S GRAND BLVD | ||||||||
| Address2: | DEPARTMENT OF NEUROLOGY & PSYCHIATRY | ||||||||
| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631041027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3149774849 | ||||||||
| FaxNumber: | 3149774876 | ||||||||
| Practice Location | |||||||||
| Address1: | AVENIDA RUI BARBOSA, 748 | ||||||||
| Address2: | AP 1100 | ||||||||
| City: | FORTALEZA | ||||||||
| State: | CEARA | ||||||||
| PostalCode: | 60115220 | ||||||||
| CountryCode: | BR | ||||||||
| TelephoneNumber: | 011558532243974 | ||||||||
| FaxNumber: | 011558533668333 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/14/2009 | ||||||||
| LastUpdateDate: | 10/14/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | MO2002003281 | MO | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
No ID Information.