Healthcare Provider Details
I. General information
NPI: 1376228312
Provider Name (Legal Business Name): LIBERTY MOBILE MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/19/2023
Last Update Date: 02/17/2026
Certification Date: 02/17/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15366 EASTWOOD TRL
SPRING HILL FL
34604-8184
US
IV. Provider business mailing address
15366 EASTWOOD TRL
SPRING HILL FL
34604-8184
US
V. Phone/Fax
- Phone: 727-366-2144
- Fax: 352-353-1168
- Phone: 727-366-2144
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TINA
MAREE
LOSAPIO
Title or Position: APRN
Credential: APRN
Phone: 727-366-2144