Bumgarner, Mariliz Borbon
Bumgarner, Mariliz Borbon is an sole proprietor health care provider with primary practice located at 5150 Curry Ford Rd , Orlando FL 32812-8744. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Bumgarner, Mariliz Borbon can be contacted via phone (407) 286-3653.Contact Information
Primary practice address
5150 Curry Ford Rd
Orlando FL 32812-8744
Phone: (407) 286-3653
Fax: (407) 286-4739
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 91688 | Florida |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | ME-91688 | Florida |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | ME91688 | Florida |
Profile Details
| NPI number | 1558366195 |
|---|---|
| LBN Legal business name | Bumgarner, Mariliz Borbon |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 20th, 2005 |
| Last updated | Jun 12th, 2024 - about 5 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558366195 | NPPES |
| Florida | Other | 52180 | BCBSH |
| Florida | MEDICAID | 1528161 | BCBSH |
| Florida | MEDICAID | 271218100 | BCBSH |
| Florida | Other | 7723670 | BCBSH |
| Florida | MEDICAID | QMP000005411144 | BCBSH |
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