Healthcare Provider Details

I. General information

NPI: 1629403514
Provider Name (Legal Business Name): BUENMED, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2013
Last Update Date: 09/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 BOOTHE CIR SUITE 100
LONGWOOD FL
32750-6751
US

IV. Provider business mailing address

1900 BOOTHE CIR SUITE 100
LONGWOOD FL
32750-6751
US

V. Phone/Fax

Practice location:
  • Phone: 407-774-6800
  • Fax: 407-774-6806
Mailing address:
  • Phone: 407-774-6800
  • Fax: 407-774-6806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. EDUARDO TOBENAS
Title or Position: DOCTOR/OWNER
Credential: D.C.
Phone: 407-774-6800