Provider Demographics
NPI:1255424255
Name:JAMES P BARTEK MD PL
Entity type:Organization
Organization Name:JAMES P BARTEK MD PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:P
Authorized Official - Last Name:BARTEK
Authorized Official - Suffix:
Authorized Official - Credentials:MD PL
Authorized Official - Phone:941-625-4357
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:941-625-1286
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:941-625-1286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME784062086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL257308300Medicaid
FL257308300Medicaid
FLK5526Medicare ID - Type UnspecifiedGROUP ID