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General NPI Number Information
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NPI Number | 1083945984
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Entity Type | Organization
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Legal Business Name | PB HEALTHCARE SVCS, INC
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Dates
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Enumeration Date | 01/18/2010
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Last Update Date | 04/04/2014
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Provider Practice Location Address
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Address Line | 50 CYPRESS POINT PKWY SUITE A3
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City | PALM COAST
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State | FL
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Zip | 32164-2500
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Country | US
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Telephone | 386-445-0977
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Fax | 386-445-0579
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Provider Business Mailing Address
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Address Line | 50 CYPRESS POINT PKWY SUITE A3
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City | PALM COAST
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State | FL
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Zip | 32164-2500
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Country | US
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Telephone | 386-445-0977
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Fax | 386-445-0579
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DR. PARMINDER S MAHAL
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Credential | M.D.
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Telephone | 386-445-0977
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME101528
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN16698
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License Number State | FL
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