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General NPI Number Information
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NPI Number | 1265861264
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Entity Type | Organization
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Legal Business Name | ALVARO R. BADA, M.D., P.A.
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Dates
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Enumeration Date | 11/11/2013
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Last Update Date | 11/11/2013
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Provider Practice Location Address
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Address Line | 18308 MURDOCK CIR UNIT 101
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City | PORT CHARLOTTE
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State | FL
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Zip | 33948-1025
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Country | US
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Telephone | 941-255-0069
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Fax | 941-255-0072
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Provider Business Mailing Address
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Address Line | 18308 MURDOCK CIR UNIT 101
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City | PORT CHARLOTTE
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State | FL
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Zip | 33948-1025
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Country | US
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Telephone | 941-255-0069
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Fax | 941-255-0072
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Authorized Official
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Title or Position | OWNER
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Name | ALVARO R BADA
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Credential | M.D.
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Telephone | 941-255-0069
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 39970
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License Number State | FL
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