Healthcare Provider Details

I. General information

NPI: 1689366205
Provider Name (Legal Business Name): FLORIDA U.S. MOBILE CARE GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2023
Last Update Date: 05/23/2023
Certification Date: 05/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6488 NW 99TH AVENUE
PARKLAND FL
33076
US

IV. Provider business mailing address

1221 BRICKELL AVE STE 900
MIAMI FL
33131-3800
US

V. Phone/Fax

Practice location:
  • Phone: 347-298-4100
  • Fax: 347-227-1368
Mailing address:
  • Phone: 347-298-4100
  • Fax: 347-227-1368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. JONA JANE TAJONERA
Title or Position: CEO
Credential:
Phone: 347-298-4100