Pro Bono Care LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

ME53634 Issued in FL

Legal business name

PRO BONO CARE LLC

Practice address

4651 Sheridan St Ste 450
Hollywood, FL 33021-3415

Phone

(954) 983-5330

Fax

(954) 983-5086

NPI assigned

May 8, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Yves S Eveillard, MDNPI 1629211560

Title

Agent Manager

Phone

(954) 983-5330

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Yves S Eveillard, MD

  • Psychiatry Physician
  • Hollywood, FL
  • NPI 1629211560
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1367971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367971200000",
    "number": "1922443613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4651 SHERIDAN ST STE 450",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213415",
            "telephone_number": "954-983-5330",
            "fax_number": "954-983-5086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4651 SHERIDAN ST STE 450",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213415",
            "telephone_number": "954-983-5330",
            "fax_number": "954-983-5086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO BONO CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-08",
        "last_updated": "2013-05-08",
        "status": "A",
        "authorized_official_last_name": "EVEILLARD",
        "authorized_official_first_name": "YVES",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "AGENT MANAGER",
        "authorized_official_telephone_number": "954-983-5330",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "FL",
            "license": "ME53634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0489379",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Adult Mental Health Clinic/Center in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Adult Mental Health Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.