Healthcare Provider Details
I. General information
NPI: 1124667902
Provider Name (Legal Business Name): CARE 4 ALL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/27/2019
Last Update Date: 12/31/2019
Certification Date: 12/31/2019
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2020 FLAMINGO DRIVE
BARTOW FL
33830
US
IV. Provider business mailing address
2020 FLAMINGO DRIVE
BARTOW FL
33830
US
V. Phone/Fax
- Phone: 863-604-0047
- Fax: 863-537-7530
- Phone: 863-604-0047
- Fax: 863-537-7530
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANED
ORBEZO
Title or Position: OWNER
Credential: MD
Phone: 863-604-0047