MEDICARE: PBND CARE INC

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	207Q00000X	Family Medicine Physician	ME0075836	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4460	OTHER	FL	COMERCIAL INS

General Provider Information

NPI Number	:	1851664536
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PBND CARE INC

Provider Business Mailing Address
First Line	:	4460 CARVER ST
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33461-2713
Country	:	US
Telephone Number	:	786-247-0057
Fax Number	:

Provider Business Practice Location Address
First Line	:	4460 CARVER ST
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33461-2713
Country	:	US
Telephone Number	:	786-247-0057
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ALFREDO J MORFFI
Credential	:
Telephone Number	:	786-247-0057

Provider Enumeration Date	:	02/11/2012
Last Update Date	:	02/11/2012

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