MEDICARE: MOBILE PHYSICIANS TEAM MANAGEMENT LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1346744364
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOBILE PHYSICIANS TEAM MANAGEMENT LLC

Provider Business Mailing Address
First Line	:	3921 ALTON RD STE 300
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-3852
Country	:	US
Telephone Number	:	863-298-6717
Fax Number	:	863-298-6717

Provider Business Practice Location Address
First Line	:	3921 ALTON RD STE 300
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-3852
Country	:	US
Telephone Number	:	863-298-6717
Fax Number	:	863-298-6717

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	TAMARA ROWLAND
Credential	:
Telephone Number	:	863-298-6717

Provider Enumeration Date	:	03/23/2018
Last Update Date	:	03/23/2018

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