MEDICARE: DR. ANTHONY BRADFORD BULLINGTON D.C.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MH7761	FL

General Provider Information

NPI Number	:	1073362646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANTHONY BRADFORD BULLINGTON D.C.C.

Provider Business Mailing Address
First Line	:	221 NE PARK ST
Second Line	:
City	:	OKEECHOBEE
State	:	FL
Zip	:	34972-2923
Country	:	US
Telephone Number	:	863-441-3894
Fax Number	:

Provider Business Practice Location Address
First Line	:	221 NE PARK ST
Second Line	:
City	:	OKEECHOBEE
State	:	FL
Zip	:	34972-2923
Country	:	US
Telephone Number	:	863-441-3894
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2024
Last Update Date	:	05/16/2024

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