Healthcare Provider Details

I. General information

NPI: 1043553324
Provider Name (Legal Business Name): MULLINS & MULLINS ENTERPRISE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2013
Last Update Date: 04/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3260 GRETNA DR
SPRING HILL FL
34609-2831
US

IV. Provider business mailing address

7364 LAGOON RD
SPRING HILL FL
34606-3714
US

V. Phone/Fax

Practice location:
  • Phone: 352-200-1689
  • Fax:
Mailing address:
  • Phone: 352-684-4984
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberAL11765
License Number StateFL

VIII. Authorized Official

Name: DEBORAH MULLINS
Title or Position: OWNER
Credential:
Phone: 352-200-1689