MEDICARE: MM777 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	261QH0100X	Health Service Clinic/Center

General Provider Information

NPI Number	:	1841080199
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MM777 INC.

Provider Business Mailing Address
First Line	:	17375 COLLINS AVE # 1603
Second Line	:
City	:	SUNNY ISLES BEACH
State	:	FL
Zip	:	33160-3410
Country	:	US
Telephone Number	:	718-736-3577
Fax Number	:

Provider Business Practice Location Address
First Line	:	17375 COLLINS AVE # 1603
Second Line	:
City	:	SUNNY ISLES BEACH
State	:	FL
Zip	:	33160-3410
Country	:	US
Telephone Number	:	718-736-3577
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MAZAL MARINA PINCHAS
Credential	:
Telephone Number	:	718-736-3577

Provider Enumeration Date	:	05/09/2025
Last Update Date	:	05/09/2025

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