Healthcare Provider Details

I. General information

NPI: 1649647132
Provider Name (Legal Business Name): P.B.F HEALTHCARE SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2015
Last Update Date: 08/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5719 RIORDAN WAY
ORLANDO FL
32808-2433
US

IV. Provider business mailing address

5719 RIORDAN WAY
ORLANDO FL
32808-2433
US

V. Phone/Fax

Practice location:
  • Phone: 407-844-1782
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TANYA BLAKE
Title or Position: CEO
Credential:
Phone: 407-844-1782