Provider Demographics
NPI:1043988934
Name:BURDELIK, CAROL LYNN (MHWC)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:LYNN
Last Name:BURDELIK
Suffix:
Gender:F
Credentials:MHWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1106 OVERLOOK CT
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34208-5715
Mailing Address - Country:US
Mailing Address - Phone:941-345-3330
Mailing Address - Fax:
Practice Address - Street 1:1106 OVERLOOK CT
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-5715
Practice Address - Country:US
Practice Address - Phone:941-345-3330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-03
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL