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General NPI Number Information
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NPI Number | 1730888199
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Entity Type | Organization
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Legal Business Name | MOBILE MEDICAL HEALTHCARE, PROFESSIONAL ASSOCIATION
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Dates
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Enumeration Date | 02/24/2023
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Last Update Date | 02/24/2023
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Provider Practice Location Address
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Address Line | 106 COMMERCE ST STE 101
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City | LAKE MARY
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State | FL
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Zip | 32746-6217
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Country | US
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Telephone | 844-553-6246
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Fax |
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Provider Business Mailing Address
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Address Line | 35 W 35TH ST FL 5
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City | NEW YORK
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State | NY
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Zip | 10001-2271
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | REVENUE CYCLE DIRECTOR
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Name | MR. BRIAN BUCKLEY
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Credential |
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Telephone | 844-553-6246
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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