Organization
PBS CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HECTOR L RODRIGUEZ JR. AB (DIRECTOR)
(407) 738-0856
Entity
Organization
Contact information
Practice address
105 E MONUMENT AVE, KISSIMMEE, FL 34741-5761
(407) 350-4138
(321) 250-7463
Mailing address
PO BOX 452848, KISSIMMEE, FL 34745-2848
(407) 350-4138
(321) 250-7463
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0108457500
—
FL
Enumeration date
05/10/2018
Last updated
02/18/2019
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