Provider Demographics
NPI:1023531704
Name:BIG BEND CARES, INC.
Entity type:Organization
Organization Name:BIG BEND CARES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:RENZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-656-2437
Mailing Address - Street 1:2201 S MONROE ST
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-6302
Mailing Address - Country:US
Mailing Address - Phone:850-656-2437
Mailing Address - Fax:
Practice Address - Street 1:2200 SOUTH MONROE ST
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-6303
Practice Address - Country:US
Practice Address - Phone:850-354-8765
Practice Address - Fax:850-900-5941
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BIG BEND CARES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-07-25
Last Update Date:2018-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No163WG0000XNursing Service ProvidersRegistered NurseGeneral PracticeGroup - Single Specialty
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty
No2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiographyGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty