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General NPI Number Information
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NPI Number | 1154502284
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Entity Type | Organization
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Legal Business Name | PASCAL BORDY MD PA
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Dates
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Enumeration Date | 11/16/2007
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Last Update Date | 07/06/2012
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Provider Practice Location Address
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Address Line | 530 TAMIAMI TRL
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City | PORT CHARLOTTE
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State | FL
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Zip | 33953-2125
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Country | US
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Telephone | 941-391-5296
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Fax | 941-375-8919
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Provider Business Mailing Address
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Address Line | 530 TAMIAMI TRL
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City | PORT CHARLOTTE
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State | FL
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Zip | 33953-2125
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Country | US
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Telephone | 941-391-5296
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Fax | 941-375-8919
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PASCAL P BORDY
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Credential | M.D.
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Telephone | 708-717-3092
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME91862
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License Number State | FL
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