Dr B Medical Pllc | |
1905 Clint Moore Rd Ste 202 Boca Raton FL 33496-2660 | |
(561) 757-5530 | |
(561) 430-3590 |
Full Name | Dr B Medical Pllc |
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Speciality | Family Medicine |
Location | 1905 Clint Moore Rd Ste 202, Boca Raton, Florida |
Authorized Official Name and Position | Allyson Christina Bagenholm (OWNER) |
Authorized Official Contact | 5617575530 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Dr B Medical Pllc 1905 Clint Moore Rd Ste 202 Boca Raton FL 33496-2660 Ph: (561) 757-5530 | Dr B Medical Pllc 1905 Clint Moore Rd Ste 202 Boca Raton FL 33496-2660 Ph: (561) 757-5530 |
NPI Number | 1881217081 |
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Provider Enumeration Date | 05/21/2020 |
Last Update Date | 12/08/2021 |
Medicare PECOS PAC ID | 3577984038 |
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Medicare Enrollment ID | O20200609001518 |
Identifier | Type | State | Issuer |
---|---|---|---|
1881217081 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Christina R Baker |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1386990968 PECOS PAC ID: 7719131069 Enrollment ID: I20130214000086 |
Provider Name | Allyson C Bagenholm |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1023279916 PECOS PAC ID: 1052580198 Enrollment ID: I20131203001359 |
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