Healthcare Provider Details

I. General information

NPI: 1295036150
Provider Name (Legal Business Name): BARDINAS MEDICAL CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2010
Last Update Date: 03/06/2023
Certification Date: 03/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14255 SW 42ND ST UNIT 13-A
MIAMI FL
33175-6408
US

IV. Provider business mailing address

3148 SW 143RD PL
MIAMI FL
33175-7435
US

V. Phone/Fax

Practice location:
  • Phone: 305-306-3400
  • Fax: 305-402-2800
Mailing address:
  • Phone: 786-712-7151
  • Fax: 305-250-5688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME106246
License Number StateFL

VIII. Authorized Official

Name: ROGELIO O BARDINAS
Title or Position: PRESIDENT
Credential: MD
Phone: 786-712-7151