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NPI Code Detail

MEDICARE: BOND CLINIC PA

MEDICARE: BOND CLINIC PA
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
1332B00000XDurable Medical Equipment & Medical Supplies606419FL

General Provider Information

NPI Number : 1629439195
Entity Type Code : Organization
Provider Name (Legal Business Name) : BOND CLINIC PA
Provider Business Mailing Address
First Line : 500 E CENTRAL AVE
Second Line :
City : WINTER HAVEN
State : FL
Zip : 33880-3053
Country : US
Telephone Number : 863-293-1191
Fax Number :
Provider Business Practice Location Address
First Line : 3000 WOODMONT AVE
Second Line :
City : WINTER HAVEN
State : FL
Zip : 33884-3800
Country : US
Telephone Number : 863-293-1191
Fax Number : 863-293-8035
Authorized Official
Title or Position : CFO
Name : MR. JASON MOERSCHBACHER
Credential :
Telephone Number : 863-293-1191
Provider Enumeration Date : 03/11/2016
Last Update Date : 08/03/2016

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Practice Fax:
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Directions to “BOND CLINIC PA ” Practice Location

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