MEDICARE: M R MEDICAL GROUP, 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	335E00000X	Prosthetic/Orthotic Supplier	PED77	FL
2	332B00000X	Durable Medical Equipment & Medical Supplies	PED77	FL

General Provider Information

NPI Number	:	1932327053
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	M R MEDICAL GROUP, INC.

Provider Business Mailing Address
First Line	:	344 LIAM AVENUE
Second Line	:
City	:	TARPON SPRINGS
State	:	FL
Zip	:	34689
Country	:	US
Telephone Number	:	866-945-0434
Fax Number	:	727-785-6128

Provider Business Practice Location Address
First Line	:	1016 OHIO AVE
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34683-4417
Country	:	US
Telephone Number	:	866-945-0434
Fax Number	:	727-785-6128

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JULIE MUELLER
Credential	:
Telephone Number	:	727-224-8698

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	02/21/2011

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