Healthcare Provider Details

I. General information

NPI: 1881949758
Provider Name (Legal Business Name): ROBERT LOUIS BARDINAS DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2012
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

231 N NEW YORK AVE
WINTER PARK FL
32789-3117
US

IV. Provider business mailing address

11 EAGLE ROCK AVE FL 2
EAST HANOVER NJ
07936-3167
US

V. Phone/Fax

Practice location:
  • Phone: 407-599-3700
  • Fax: 407-599-3701
Mailing address:
  • Phone: 407-599-3700
  • Fax: 407-599-3701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT27532
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA01514500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: