MEDICARE: DR. MATTHEW CAMPBELL BARDIN PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P1200X	Pharmacotherapy Pharmacist	PS35161	FL
2	1835N1003X	Nutrition Support Pharmacist	PS35161	FL
3	183500000X	Pharmacist	PS35161	FL

General Provider Information

NPI Number	:	1114920337
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW CAMPBELL BARDIN PHARM.D.

Provider Business Mailing Address
First Line	:	6403 S QUEENSWAY DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33617-2439
Country	:	US
Telephone Number	:	813-980-3581
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 N ALEXANDER ST
Second Line	:
City	:	PLANT CITY
State	:	FL
Zip	:	33563-4303
Country	:	US
Telephone Number	:	813-757-1233
Fax Number	:	813-757-1234

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	09/11/2025

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