MEDICARE: FLORIDA MOBILE MED 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	:	1932708781
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORIDA MOBILE MED INC.

Provider Business Mailing Address
First Line	:	9250 BAY PLAZA BLVD STE 319
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33619-4464
Country	:	US
Telephone Number	:	813-270-9300
Fax Number	:

Provider Business Practice Location Address
First Line	:	9250 BAY PLAZA BLVD STE 319
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33619-4464
Country	:	US
Telephone Number	:	813-270-9300
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. LORI BARNES
Credential	:	APRN
Telephone Number	:	813-270-9300

Provider Enumeration Date	:	10/22/2020
Last Update Date	:	10/22/2020

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