=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528703568
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MEDBILL PLUS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/04/2022
-----------------------------------------------------
Last Update Date | 05/04/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9000 WEST SAMPLE ROAD SUITE 310
-----------------------------------------------------
City | CORAL SPRINGS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33065
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-771-0183
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1627 NE 32ND ST
-----------------------------------------------------
City | OAKLAND PARK
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33334-5319
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-771-0183
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | TANGELA L PRESIDENT
-----------------------------------------------------
Credential | OWNER
-----------------------------------------------------
Telephone | 786-771-0183
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251V00000X
-----------------------------------------------------
Taxonomy Name | Voluntary or Charitable Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------