Peter Michael Pardoll, M.D.
Individual provider Active NPI Gastroenterology Physician · Treasure Island, FL
NPI 1013288604 · NPPES record last updated Jan 13, 2012
Key facts
- NPI
- 1013288604
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gastroenterology Physician 207RG0100X
- License
- ME24487 (FL)
- Practice address
- 34 Paradise LN
Treasure Island, FL 33706-1129 - Phone
- (727) 422-5464
- Fax
- (727) 360-5352
- NPI assigned
- Jan 13, 2012
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME24487 | FL | MD | Gastroenterology Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | ME24487 | FL | Yes |
Addresses
Primary practice location
34 Paradise LN
Treasure Island, FL 33706-1129
Mailing address
34 Paradise Lane
Treasure Island, FL 33706
Phone (727) 422-5464
Other providers in Treasure Island, FL
- Joni L McGurk
- Cheri Marie McNally
- Kyra Alexa Muhar
- Deborah Nolan Nestor
- Xiomara Ospina Restrepo
- Laura Anne Pasker
- Lauren Ann Porto
- Premier St. Petersburg
- April Primous
- Megan Marie Ray
All providers in Treasure Island, FL · Gastroenterology Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 13, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.