# MOBILE VISITING PRACTITIONERS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265915359
- **Authorized official:** EDWARD R KOP (DIRECTOR OF OPERATIONS)
- **Authorized official phone:** (352) 362-0627

## Contact information

- **Practice address:** 140 S BEACH ST STE 202, DAYTONA BEACH, FL 32114-4409
- **Practice address phone:** (888) 506-8836
- **Practice address fax:** (888) 506-8837
- **Mailing address:** 140 S BEACH ST STE 202, DAYTONA BEACH, FL 32114-4409
- **Mailing address phone:** (888) 506-8836
- **Mailing address fax:** (888) 506-8837

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 09/13/2018
- **Last updated:** 11/05/2020