MEDICARE: MOBILITY SCOOTER CENTER INC

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	332B00000X	Durable Medical Equipment & Medical Supplies	609	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	R8501	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1801891494
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOBILITY SCOOTER CENTER INC

Provider Business Mailing Address
First Line	:	748 N HARBOR CITY BLVD
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32935-6842
Country	:	US
Telephone Number	:	321-752-4041
Fax Number	:	321-752-4085

Provider Business Practice Location Address
First Line	:	748 N HARBOR CITY BLVD
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32935-6842
Country	:	US
Telephone Number	:	321-752-4041
Fax Number	:	321-752-4085

Authorized Official
Title or Position	:	OWNER
Name	:	ELLIE RUDOLPH
Credential	:
Telephone Number	:	321-752-4041

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	08/12/2010

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Directions to “MOBILITY SCOOTER CENTER INC ” Practice Location

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