Provider Demographics
NPI:1215207550
Name:VONDA BOBART MD PA
Entity Type:Organization
Organization Name:VONDA BOBART MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOBART
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-693-9050
Mailing Address - Street 1:1021 HOLLISTER DR
Mailing Address - Street 2:
Mailing Address - City:WEST MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32904-8727
Mailing Address - Country:US
Mailing Address - Phone:908-653-9399
Mailing Address - Fax:
Practice Address - Street 1:1021 HOLLISTER DR
Practice Address - Street 2:
Practice Address - City:WEST MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32904-8727
Practice Address - Country:US
Practice Address - Phone:908-653-9399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-04
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty