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General NPI Number Information
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NPI Number | 1932974367
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Entity Type | Organization
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Legal Business Name | MOBILE CARE ON DEMAND LLC
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Dates
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Enumeration Date | 11/15/2023
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Last Update Date | 11/15/2023
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Provider Practice Location Address
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Address Line | 3575 WEBBER ST STE 106
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City | SARASOTA
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State | FL
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Zip | 34239-4930
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Country | US
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Telephone | 561-714-9747
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Fax |
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Provider Business Mailing Address
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Address Line | 3575 WEBBER ST STE 106
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City | SARASOTA
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State | FL
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Zip | 34239-4930
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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 | CEO
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Name | TAMIRAH BONABY
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Credential | NP
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Telephone | 561-714-9747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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