Healthcare Provider Details
I. General information
NPI: 1578714739
Provider Name (Legal Business Name): MBT CONSULTANTS PL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/07/2008
Last Update Date: 10/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13660 JOG RD SUITE # 6
DELRAY BEACH FL
33446-3806
US
IV. Provider business mailing address
13660 JOG RD SUITE # 6
DELRAY BEACH FL
33446-3806
US
V. Phone/Fax
- Phone: 561-637-1446
- Fax: 561-637-1448
- Phone: 561-637-1446
- Fax: 561-637-1448
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332BP3500X |
| Taxonomy | Parenteral & Enteral Nutrition Supplies (DME) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MARGARETA
BERNARD
TINSLEY
Title or Position: OWNER/MANAGER
Credential: PHARMD
Phone: 561-637-1446