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Individual
BOBBY JOHN ARDILA
Active
Individual
BOBBY JOHN ARDILA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9102779
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
291863300
—
FL
Enumeration date
04/04/2006
Last updated
04/20/2009
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