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General NPI Number Information
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NPI Number | 1558150755
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Entity Type | Organization
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Legal Business Name | ADVENTHEALTH BOND CLINIC, INC.
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Dates
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Enumeration Date | 05/05/2025
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 500 E CENTRAL AVE
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City | WINTER HAVEN
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State | FL
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Zip | 33880-3053
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Country | US
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Telephone | 863-293-1191
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 931558
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City | ATLANTA
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State | GA
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Zip | 31193-1558
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | VADYM DIDENKO
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Credential |
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Telephone | 813-803-4004
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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