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12832 Nw Central Ave Bristol FL 32321 | |
| (850) 643-2415 | |
| (850) 643-5689 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Public Health, Federal |
| Location | 12832 Nw Central Ave, Bristol, Florida |
| Authorized Official Name and Position | Eugene G. Charbonneau (DIRECTOR) |
| Authorized Official Contact | 8506432415 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 489 Bristol FL 32321-0489 Ph: (850) 643-2415 | 12832 Nw Central Ave Bristol FL 32321 Ph: (850) 643-2415 |
| NPI Number | 1629259940 |
|---|---|
| Provider Enumeration Date | 11/15/2007 |
| Last Update Date | 11/28/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629259940 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP0904X | Clinic/center - Public Health, Federal | (* (Not Available)) | Primary |
Pancare Of Florida, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11033 Nw State Road 20, Bristol, FL 32321 Phone: 850-643-1155 Fax: 850-643-1163 |