Healthcare Provider Details

I. General information

NPI: 1962322933
Provider Name (Legal Business Name): MBM MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3550 S TAMIAMI TRL STE 301
SARASOTA FL
34239-6014
US

IV. Provider business mailing address

2350 ROSE ST
SARASOTA FL
34239-5322
US

V. Phone/Fax

Practice location:
  • Phone: 941-366-4422
  • Fax: 941-366-4422
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: PATRICK SWEENEY MULLEN
Title or Position: OWNER
Credential: MD
Phone: 941-366-4422