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NPI Code Detail

MEDICARE: MR. THOMAS MARTIN BONDS I

MEDICARE:  MR. THOMAS MARTIN BONDS I
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
1311ZA0620XAdult Care Home FacilityFL

General Provider Information

NPI Number : 1417753898
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. THOMAS MARTIN BONDS I
Provider Business Mailing Address
First Line : PO BOX 3731
Second Line :
City : LAKE WALES
State : FL
Zip : 33859-3731
Country : US
Telephone Number : 863-412-9702
Fax Number :
Provider Business Practice Location Address
First Line : 2202 BOUYER ST
Second Line :
City : LAKE WALES
State : FL
Zip : 33898-8552
Country : US
Telephone Number : 863-412-9702
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2025
Last Update Date : 02/24/2025

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Directions to “ MR. THOMAS MARTIN BONDS I ” Practice Location

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