MEDICARE: DR. TAREK BARDAWIL M.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	207VG0400X	Gynecology Physician	ME99212	FL

General Provider Information

NPI Number	:	1215154570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TAREK BARDAWIL M.D.

Provider Business Mailing Address
First Line	:	3659 S MIAMI AVE STE 5004
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33133-4231
Country	:	US
Telephone Number	:	305-602-3022
Fax Number	:	786-359-4848

Provider Business Practice Location Address
First Line	:	3659 S MIAMI AVE STE 5004
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33133-4231
Country	:	US
Telephone Number	:	305-602-3022
Fax Number	:	786-359-4848

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

Provider Enumeration Date	:	04/19/2007
Last Update Date	:	01/16/2020

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