Individual
DR. MARILIZ BORBON BUMGARNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5150 CURRY FORD RD, ORLANDO, FL 32812-8744
(407) 286-3653
(407) 286-4739
Mailing address
5150 CURRY FORD RD, ORLANDO, FL 32812-8744
(239) 600-9389
(407) 286-4739
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
91688
FL
208000000X
Pediatrics Physician
ME-91688
FL
208000000X
Pediatrics Physician
Primary
ME91688
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1528161
—
FL
05
—
271218100
—
FL
01
—
52180
BCBSH
FL
01
—
7723670
AETNA
FL
05
—
QMP000005411144
—
FL
Enumeration date
06/20/2005
Last updated
06/12/2024
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