Basic Information
| Provider Information | |||||||||
| NPI: | 1548553712 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | QUINDARDO | ||||||||
| FirstName: | ANTHONY | ||||||||
| MiddleName: | JAMES | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8201 W. IRLO BRONSON HIGHWAY | ||||||||
| Address2: | |||||||||
| City: | KISSIMMEE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 34747 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4072002300 | ||||||||
| FaxNumber: | 4072001353 | ||||||||
| Practice Location | |||||||||
| Address1: | 16332 CONNEAUT LAKE RD | ||||||||
| Address2: | |||||||||
| City: | MEADVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 163353843 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8143362935 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/20/2011 | ||||||||
| LastUpdateDate: | 12/23/2015 | ||||||||
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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 | 363AM0700X | MA054510 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical | 363AM0700X | OA002568 | PA | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.