Healthcare Provider Details

I. General information

NPI: 1174957468
Provider Name (Legal Business Name): MECNB, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2013
Last Update Date: 07/03/2025
Certification Date: 07/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6515 S KANNER HWY
STUART FL
34997-6330
US

IV. Provider business mailing address

2720 10TH AVE N STE 100
PALM SPRINGS FL
33461-3100
US

V. Phone/Fax

Practice location:
  • Phone: 772-463-1123
  • Fax: 772-463-3072
Mailing address:
  • Phone: 561-540-4446
  • Fax: 561-540-4430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number60929
License Number StateFL

VIII. Authorized Official

Name: ROBERT RODRIGUEZ
Title or Position: CEO
Credential:
Phone: 201-505-4735