Healthcare Provider Details

I. General information

NPI: 1487162632
Provider Name (Legal Business Name): PEDIATRICS AND FAMILY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2018
Last Update Date: 06/20/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5150 CURRY FORD RD
ORLANDO FL
32812-8744
US

IV. Provider business mailing address

5150 CURRY FORD RD
ORLANDO FL
32812-8744
US

V. Phone/Fax

Practice location:
  • Phone: 407-286-3653
  • Fax: 407-286-4739
Mailing address:
  • Phone: 239-600-9389
  • Fax: 407-286-4739

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME91688
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. MARILIZ BORBON BUMGARNER
Title or Position: OWNER
Credential: MD
Phone: 239-600-9389