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Organization
MOBILE MEDICAL OPERATING COMPANY LLC
Active
Organization
MOBILE MEDICAL OPERATING COMPANY LLC
Active
Other names
Mobile Medical
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT YOUNG (SECRETARY & CAO)
(904) 733-1003
Entity
Organization
Contact information
Practice address
1840 SE PORT ST LUCIE BLVD STE 1840, PORT ST LUCIE, FL 34952-5545
(772) 221-7620
(772) 221-9903
Mailing address
4655 SALISBURY RD STE 110, JACKSONVILLE, FL 32256-0957
(904) 733-1003
(904) 448-8855
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
208D00000X
General Practice Physician
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117201700
—
FL
01
—
13404
AHCA
FL
Enumeration date
02/01/2022
Last updated
09/25/2024
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