Provider Demographics
NPI:1942769534
Name:CBD SKELETAL SOLUTIONS, LLC
Entity Type:Organization
Organization Name:CBD SKELETAL SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARA
Authorized Official - Middle Name:
Authorized Official - Last Name:BORNT-DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-586-6752
Mailing Address - Street 1:630 TENNIS CLUB DRIVE
Mailing Address - Street 2:OUTERBRIDGE - 407
Mailing Address - City:FT. LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33311
Mailing Address - Country:US
Mailing Address - Phone:717-586-6752
Mailing Address - Fax:717-757-5012
Practice Address - Street 1:630 TENNIS CLUB DRIVE
Practice Address - Street 2:OUTERBRIDGE - 407
Practice Address - City:FT. LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33311
Practice Address - Country:US
Practice Address - Phone:717-586-6752
Practice Address - Fax:717-757-5012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-14
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies