MEDICARE: GEORGE BORDENAVE MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	ME0055836	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437305570
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GEORGE BORDENAVE MD PA

Provider Business Mailing Address
First Line	:	8720 N KENDALL DR STE 115
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33176-2208
Country	:	US
Telephone Number	:	305-446-2444
Fax Number	:	305-663-1025

Provider Business Practice Location Address
First Line	:	8720 N KENDALL DR STE 115
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33176-2208
Country	:	US
Telephone Number	:	305-446-2444
Fax Number	:	305-663-1025

Authorized Official
Title or Position	:	MEDICAL DOCTOR
Name	:	GEORGE BORDENAVE
Credential	:	MD
Telephone Number	:	305-446-2444

Provider Enumeration Date	:	08/08/2008
Last Update Date	:	06/24/2020

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