Provider Demographics
NPI:1730170861
Name:BARDEN, ROBERT E (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:E
Last Name:BARDEN
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 1:2234 COLONIAL BLVD
Mailing Address - Street 2:MANAGED CARE DEPT
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1412
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:
Practice Address - Street 1:8931 COLONIAL CENTER DR
Practice Address - Street 2:SUITE 400
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33905-7816
Practice Address - Country:US
Practice Address - Phone:239-334-6626
Practice Address - Fax:239-334-0404
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME17746207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1192940OtherWELLCARE
FL05364OtherBCBS FL
FLP00888343OtherRAILROAD MEDICARE
FL1694308OtherCIGNA
FL057963700Medicaid
FL4389614OtherAETNA
FLD61223Medicare UPIN
FL057963700Medicaid
FL05364WMedicare PIN