MEDICARE: PEDIATRICS AND FAMILY CARE LLC

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	332B00000X	Durable Medical Equipment & Medical Supplies
2	208000000X	Pediatrics Physician	ME91688	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7VFHM	OTHER	FL	BCBSFL
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487162632
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEDIATRICS AND FAMILY CARE LLC

Provider Business Mailing Address
First Line	:	5150 CURRY FORD RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32812-8744
Country	:	US
Telephone Number	:	239-600-9389
Fax Number	:	407-286-4739

Provider Business Practice Location Address
First Line	:	5150 CURRY FORD RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32812-8744
Country	:	US
Telephone Number	:	407-286-3653
Fax Number	:	407-286-4739

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MARILIZ BORBON BUMGARNER
Credential	:	MD
Telephone Number	:	239-600-9389

Provider Enumeration Date	:	01/22/2018
Last Update Date	:	06/20/2025

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