Healthcare Provider Details

I. General information

NPI: 1750156287
Provider Name (Legal Business Name): GRACE MOBILE HEALTHCARE SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2023
Last Update Date: 11/15/2023
Certification Date: 11/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9825 MARINA BLVD STE 100
BOCA RATON FL
33428-6628
US

IV. Provider business mailing address

4787 NW 72ND PL
COCONUT CREEK FL
33073-2741
US

V. Phone/Fax

Practice location:
  • Phone: 848-256-0360
  • Fax:
Mailing address:
  • Phone: 954-822-9322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MS. MIRDINE MINVIEL
Title or Position: OWNER
Credential: NP
Phone: 954-822-9322