OrganizationActive
Cardinal Dermatology LLC
NPI 1174390926 · Dermatology Physician · South Bend, IN
Provider details
- NPI number
- 1174390926
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Luiz Pantalena Filho, Member(650) 387-9765
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Procedural Dermatology Physician207NS0135X
Allopathic & Osteopathic Physicians
- MOHS-Micrographic Surgery Physician207ND0101X
Allopathic & Osteopathic Physicians
Practice location
4322 Lafayette Blvd
South Bend, IN 46614
Phone: (574) 391-1111
Approximate (ZIP-level) locationGet directions
Mailing address
4322 S Lafayette Blvd
South Bend, IN 46614-2189
Registry dates
- Enumerated
- 2023-12-11
- Last updated
- 2025-01-02
- Certified
- 2024-12-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.