Provider Demographics
NPI:1023422870
Name:BORDAS, NICOLAS EDUARDO (MD)
Entity type:Individual
Prefix:DR
First Name:NICOLAS
Middle Name:EDUARDO
Last Name:BORDAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1026 GOODYEAR AVE STE 302B
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35903-1194
Mailing Address - Country:US
Mailing Address - Phone:256-489-0899
Mailing Address - Fax:866-265-9563
Practice Address - Street 1:1026 GOODYEAR AVE STE 302B
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35903-1194
Practice Address - Country:US
Practice Address - Phone:256-485-0899
Practice Address - Fax:866-265-9563
Is Sole Proprietor?:No
Enumeration Date:2014-06-19
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL145583207RI0200X
PR31254-R390200000X
AL41419207RI0200X
PR19185207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine