Individual
BRIAN D TARDIF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
10475 CENTURION PKWY N, SUITE 220, JACKSONVILLE, FL 32256-5003
(904) 634-0640
(904) 634-0203
Mailing address
6500 BOWDEN RD, SUITE 103, JACKSONVILLE, FL 32216-8070
(904) 634-0640
(904) 634-0203
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9106048
FL
Other
Enumeration date
06/30/2011
Last updated
03/25/2015
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