Brianna Board

Individual provider Active NPI Case Manager/Care Coordinator · Bartow, FL

NPI 1609548676 · NPPES record last updated Sep 29, 2021

Key facts

NPI
1609548676
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
1239 E Main St
Bartow, FL 33830-5058
Phone
(863) 519-0575
Fax
(863) 582-9251
NPI assigned
Sep 29, 2021
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Yes

Addresses

Primary practice location

1239 E Main St
Bartow, FL 33830-5058

Mailing address

PO Box 1559
Bartow, FL 33831-1559
Phone (863) 519-0575

Other providers in Bartow, FL

All providers in Bartow, FL · Case Manager/Care Coordinator in Florida

Sources for this page

Verify at the official NPI Registry.