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Male or Other

Christopher J. Bordelon PA-C

Medical Physician Assistant in Tampa, FL(View on Map)

Full Name

Christopher Jacob Bordelon PA-C

NPI Number

1548756893

NPI Type

Individual Provider

Gender

Male

Enumeration Date

07/10/2018

Specialties

(Taxonomies)

Name

Medical Physician Assistant

Code

363AM0700X

Primary Taxonomy

Yes

Licenses

State

Florida
Missouri

License Number

PA9111443
2018024459

Contact
Information

Purpose

Mailing
Location

Address

10414 NIGHTENGALE DR
2550 W DR MARTIN LUTHER KING JR BLVD STE B

City

Riverview
Tampa

State

FL
FL

Postal Code

33569-4125
33607-6302

Country

US
US

Telephone Number

(813) 789-0565
(813) 876-6483

Identifiers

Identifier

101257900

Identifier State

FL

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 09/15/2021

Provider Address

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