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General NPI Number Information
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NPI Number | 1487446985
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Entity Type | Organization
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Legal Business Name | MOBILITY CLINIC LLC
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Dates
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Enumeration Date | 05/20/2025
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 4809 MEMORIAL HWY STE 200
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City | TAMPA
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State | FL
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Zip | 33634-7515
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Country | US
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Telephone | 813-517-1742
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Fax |
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Provider Business Mailing Address
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Address Line | 4809 MEMORIAL HWY STE 200
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City | TAMPA
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State | FL
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Zip | 33634-7515
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Country | US
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Telephone | 813-517-1742
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ARLENE GILLIS
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Credential | LPO, CP
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Telephone | 813-517-1741
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 222Z00000X
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Taxonomy Name | Orthotist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 224L00000X
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Taxonomy Name | Pedorthist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225000000X
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Taxonomy Name | Orthotic Fitter
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 224P00000X
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Taxonomy Name | Prosthetist
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License Number |
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License Number State |
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