MEDICARE: MUX BALANCED CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1679421242
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MUX BALANCED CARE LLC

Provider Business Mailing Address
First Line	:	201 LITHIA PINECREST RD
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33511-5307
Country	:	US
Telephone Number	:	813-502-8821
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 LITHIA PINECREST RD
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33511-5307
Country	:	US
Telephone Number	:	813-502-8821
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CASSANDRA JENKINS
Credential	:	FNP-BC
Telephone Number	:	813-502-8821

Provider Enumeration Date	:	03/19/2026
Last Update Date	:	03/19/2026

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