Individual
REUT BARDACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M,D.
Contact information
Practice address
2043 LITTLE RD, TRINITY, FL 34655
(727) 846-7000
(877) 260-1182
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(727) 376-3798
(727) 375-0678
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME111975
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004662800
—
FL
01
—
OD543
MEDICARE HF
FL
Enumeration date
03/27/2012
Last updated
09/22/2021
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