| Bardisa Lyl Center, Inc | |
|
7374 Sw 93rd Ave Ste 202 Miami FL 33173-3246 | |
| (305) 661-2002 | |
| Not Available |
| Full Name | Bardisa Lyl Center, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 7374 Sw 93rd Ave Ste 202, Miami, Florida |
| Authorized Official Name and Position | Rosalind Bardisa (DOCTOR) |
| Authorized Official Contact | 3056612002 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bardisa Lyl Center, Inc 7374 Sw 93rd Ave Ste 202 Miami FL 33173-3246 Ph: (305) 661-2002 | Bardisa Lyl Center, Inc 7374 Sw 93rd Ave Ste 202 Miami FL 33173-3246 Ph: (305) 661-2002 |
| NPI Number | 1184286890 |
|---|---|
| Provider Enumeration Date | 07/02/2019 |
| Last Update Date | 07/27/2020 |
| Medicare PECOS PAC ID | 4587992078 |
|---|---|
| Medicare Enrollment ID | O20190821004053 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184286890 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| Provider Name | Roselind H Bardisa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881791234 PECOS PAC ID: 5496771248 Enrollment ID: I20051024000138 |
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