Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Carlos Bastardo

Individual provider Prevention Professional · NPI 1417492281

Mr. Carlos Bastardo is a Prevention Professional in Plymouth, Indiana. Licensed in Indiana. Registered with an NPI since 2017.

Licensed in
IN
In the registry since
2017
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Practice location Address checks out

11191 Shadylane Dr
Plymouth, IN 46563-8623
Phone: (574) 936-4152
Fax: (312) 256-9390
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Prevention Professional (primary) Taxonomy 405300000X · Licence 3577690 (IN)

Record details

NPI number1417492281
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 3, 2017
Last updated in NPPESJanuary 3, 2017