MEDICARE: MARK BUBON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist
2	225100000X	Physical Therapist	PT6805	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	6805	OTHER	FL	LICENSE #

General Provider Information

NPI Number	:	1275640427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK BUBON

Provider Business Mailing Address
First Line	:	332 FOREST PARK CIR
Second Line	:
City	:	LONGWOOD
State	:	FL
Zip	:	32779-5870
Country	:	US
Telephone Number	:	407-862-9488
Fax Number	:

Provider Business Practice Location Address
First Line	:	4106 W LAKE MARY BLVD STE 320
Second Line	:
City	:	LAKE MARY
State	:	FL
Zip	:	32746-3344
Country	:	US
Telephone Number	:	407-333-3971
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2006
Last Update Date	:	08/01/2025

Similar Medicare Providers

1063651131 — DR. NATHAN CHRISTOPHER DEANGELIS D.O.
Practice Location Address:

4106 W LAKE MARY BLVD STE 100
LAKE MARY, FL
32746-3344

Practice Phone: 407-562-5930
Practice Fax: 407-562-5931

1831164235 — DR. MICHAEL D FRIEDMAN MD
Practice Location Address:

4106 W LAKE MARY BLVD STE 215
LAKE MARY, FL
32746-3344

Practice Phone: 407-332-7700
Practice Fax: 321-275-0344

1427023829 — CENTRAL FLORIDA UROLOGY ASSOCIATES
Practice Location Address:

4106 W LAKE MARY BLVD STE 215
LAKE MARY, FL
32746-3344

Practice Phone: 407-332-7700
Practice Fax: 321-275-0344

1376518431 — CHARLES N WITTEN MD
Practice Location Address:

4106 W LAKE MARY BLVD STE 215
LAKE MARY, FL
32746-3344

Practice Phone: 407-332-7700
Practice Fax: 321-275-0339

1144266974 — JOHN F RYAN M.D.
Practice Location Address:

4106 W LAKE MARY BLVD STE 301
LAKE MARY, FL
32746-3344

Practice Phone: 407-333-2503
Practice Fax: 407-333-0962

1144330663 — SHANE MILLER
Practice Location Address:

4106 W LAKE MARY BLVD STE 320
LAKE MARY, FL
32746-3344

Practice Phone: 407-333-3971
Practice Fax:

Directions to “ MARK BUBON ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.