| Pro Bono Care Llc | |
|
4651 Sheridan St Ste 450 Hollywood FL 33021-3415 | |
| (954) 983-5330 | |
| (954) 983-5086 |
| Full Name | Pro Bono Care Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4651 Sheridan St Ste 450, Hollywood, Florida |
| Authorized Official Name and Position | Yves S Eveillard (AGENT MANAGER) |
| Authorized Official Contact | 9549835330 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pro Bono Care Llc 4651 Sheridan St Ste 450 Hollywood FL 33021-3415 Ph: (954) 983-5330 | Pro Bono Care Llc 4651 Sheridan St Ste 450 Hollywood FL 33021-3415 Ph: (954) 983-5330 |
| NPI Number | 1922443613 |
|---|---|
| Provider Enumeration Date | 05/08/2013 |
| Last Update Date | 05/08/2013 |
| Medicare PECOS PAC ID | 3173763216 |
|---|---|
| Medicare Enrollment ID | O20130712000334 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922443613 | NPI | - | NPPES |
| 0489379 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | ME53634 (Florida) | Primary |
| Provider Name | Yves S Eveillard |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629211560 PECOS PAC ID: 5799925830 Enrollment ID: I20130801000575 |
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