Individual
BACH ARDALAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1475 NW 12TH AVE, MIAMI, FL 33136-1002
(305) 243-1000
Mailing address
1500 NW 12TH AVE, JMT EAST 1007, MIAMI, FL 33136-1028
(305) 243-4664
(305) 243-9927
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
ME59464
FL
207RX0202X
Medical Oncology Physician
ME59464
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0608041-00
—
FL
Enumeration date
06/15/2006
Last updated
02/25/2013
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