Healthcare Provider Details

I. General information

NPI: 1689539793
Provider Name (Legal Business Name): BM MEDICAL CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2025
Last Update Date: 12/20/2025
Certification Date: 12/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

199 AVENUE B NW STE 205-3
WINTER HAVEN FL
33881-4546
US

IV. Provider business mailing address

709 LAMP POST LN
LAKELAND FL
33809-6614
US

V. Phone/Fax

Practice location:
  • Phone: 863-289-7081
  • Fax:
Mailing address:
  • Phone: 863-289-7081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: BERNARDO MALAGA
Title or Position: PRESIDENT
Credential: MD
Phone: 863-289-7081