Healthcare Provider Details

I. General information

NPI: 1225484272
Provider Name (Legal Business Name): M & M MEDICAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2016
Last Update Date: 01/13/2023
Certification Date: 01/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5458 SE MAJOR WAY
STUART FL
34997-2420
US

IV. Provider business mailing address

5458 SE MAJOR WAY
STUART FL
34997-2420
US

V. Phone/Fax

Practice location:
  • Phone: 561-328-3610
  • Fax: 844-861-3079
Mailing address:
  • Phone: 561-328-3610
  • Fax: 844-861-3079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP3388432
License Number StateFL

VIII. Authorized Official

Name: MICHELE T THUNE
Title or Position: PRESIDENT
Credential: ARNP
Phone: 561-328-3610