Organization
PRO BONO CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YVES S EVEILLARD MD (AGENT MANAGER)
(954) 983-5330
Entity
Organization
Contact information
Practice address
4651 SHERIDAN ST STE 450, HOLLYWOOD, FL 33021-3415
(954) 983-5330
(954) 983-5086
Mailing address
4651 SHERIDAN ST STE 450, HOLLYWOOD, FL 33021-3415
(954) 983-5330
(954) 983-5086
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
ME53634
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0489379
—
FL
Enumeration date
05/08/2013
Last updated
05/08/2013
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