Provider Demographics
NPI:1881949758
Name:BARDINAS, ROBERT LOUIS (DPT)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:LOUIS
Last Name:BARDINAS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 EAGLE ROCK AVE
Mailing Address - Street 2:FL 2
Mailing Address - City:EAST HANOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07936-3167
Mailing Address - Country:US
Mailing Address - Phone:407-599-3700
Mailing Address - Fax:407-599-3701
Practice Address - Street 1:231 N NEW YORK AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-3117
Practice Address - Country:US
Practice Address - Phone:407-599-3700
Practice Address - Fax:407-599-3701
Is Sole Proprietor?:No
Enumeration Date:2012-07-17
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT27532225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist