Provider Demographics
NPI:1669453270
Name:BARTEK, JAMES P (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:P
Last Name:BARTEK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2525 HARBOR BLVD
Mailing Address - Street 2:UNIT 201B
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33952-5317
Mailing Address - Country:US
Mailing Address - Phone:941-625-4357
Mailing Address - Fax:941-625-5306
Practice Address - Street 1:2525 HARBOR BLVD
Practice Address - Street 2:UNIT 201B
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-5317
Practice Address - Country:US
Practice Address - Phone:941-625-4357
Practice Address - Fax:941-625-5306
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME784062086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL257308300Medicaid
FLK5526Medicare ID - Type UnspecifiedGROUP ID
FL47193YMedicare ID - Type Unspecified
FL257308300Medicaid