| Michael Bombka Llc | |
|
2605 W Lake Mary Blvd Lake Mary FL 32746-3568 | |
| (407) 463-4907 | |
| Not Available |
| Full Name | Michael Bombka Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2605 W Lake Mary Blvd, Lake Mary, Florida |
| Authorized Official Name and Position | Michael Allan Bombka (PRESIDENT) |
| Authorized Official Contact | 4074634907 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Bombka Llc 108 Homestead Ave Debary FL 32713-3816 Ph: (407) 463-4907 | Michael Bombka Llc 2605 W Lake Mary Blvd Lake Mary FL 32746-3568 Ph: (407) 463-4907 |
| NPI Number | 1669913430 |
|---|---|
| Provider Enumeration Date | 03/14/2017 |
| Last Update Date | 03/14/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669913430 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | MH7297 (Florida) | Primary |
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