Healthcare Provider Details

I. General information

NPI: 1992511273
Provider Name (Legal Business Name): TANDEMCARE PROVIDER GROUP, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2024
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2332 GALIANO ST FL 2
CORAL GABLES FL
33134-5402
US

IV. Provider business mailing address

2332 GALIANO ST FL 2
CORAL GABLES FL
33134-5402
US

V. Phone/Fax

Practice location:
  • Phone: 844-826-3364
  • Fax: 844-826-3364
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. VIKRAM BAKHRU
Title or Position: PRESIDENT
Credential: MD
Phone: 202-487-0801