Healthcare Provider Details

I. General information

NPI: 1487913364
Provider Name (Legal Business Name): MB 4 YOU, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2012
Last Update Date: 05/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3457 ALDRIDGE RD E
JACKSONVILLE BEACH FL
32250-1503
US

IV. Provider business mailing address

3457 ALDRIDGE RD E
JACKSONVILLE BEACH FL
32250-1503
US

V. Phone/Fax

Practice location:
  • Phone: 904-683-5370
  • Fax:
Mailing address:
  • Phone: 904-683-5370
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name: PEGGY A ARRANZ
Title or Position: OWNER/CFO
Credential:
Phone: 904-683-5370