Provider Demographics
NPI:1295199891
Name:PARDO, BRYAN WILLIAM
Entity type:Individual
Prefix:
First Name:BRYAN
Middle Name:WILLIAM
Last Name:PARDO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 LINCOLN RD STE 8L
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-3025
Mailing Address - Country:US
Mailing Address - Phone:305-709-3356
Mailing Address - Fax:562-262-0517
Practice Address - Street 1:407 LINCOLN RD STE 8L
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-3025
Practice Address - Country:US
Practice Address - Phone:305-709-3356
Practice Address - Fax:562-262-0517
Is Sole Proprietor?:No
Enumeration Date:2016-04-09
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME139883207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine