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General NPI Number Information
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NPI Number | 1821978834
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Entity Type | Individual
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Provider Name | ALEXANDER FARDMAN MD
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Gender | Male
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Dates
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Enumeration Date | 09/03/2025
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 655 W 8TH ST
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City | JACKSONVILLE
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State | FL
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Zip | 32209-6511
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Country | US
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Telephone | 904-244-2636
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Fax |
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Provider Business Mailing Address
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Address Line | 70 PAVIA PL
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City | SAINT JOHNS
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State | FL
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Zip | 32259-2361
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Country | US
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Telephone | 904-789-9982
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0001X
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Taxonomy Name | Advanced Heart Failure and Transplant Cardiology Physician
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License Number | 1959
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 1959
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License Number State | FL
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