Individual
BORDIN INTACHAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2001 KINGSLEY AVE, ORANGE PARK, FL 32073-5148
(904) 639-2000
Mailing address
2001 KINGSLEY AVE, ORANGE PARK, FL 32073-5148
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME158369
FL
Other
Enumeration date
04/08/2020
Last updated
08/09/2024
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