Organization
PBT LLC
Active
Other names
PBT, PBT.LLC
Organization subpart
No
Provider details
NPI number
Authorized official
CARANETTA GODBOLT (OWNER)
(689) 271-5583
Entity
Organization
Contact information
Practice address
2404 WILLOW PARK CT, KISSIMMEE, FL 34758-5007
(689) 271-5583
Mailing address
2404 WILLOW PARK CT, KISSIMMEE, FL 34758-5007
(689) 271-5583
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NO
—
FL
Enumeration date
10/03/2022
Last updated
10/03/2022
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