# MAC INNOVATION

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

## Provider details

- **NPI number:** 1619811056
- **Authorized official:** MRS. CASSANDRA SYLVIA YOUNG (CEO)
- **Authorized official phone:** (520) 904-5035

## Contact information

- **Practice address:** 1460 S MCCALL RD STE 1A, ENGLEWOOD, FL 34223-4824
- **Practice address phone:** (520) 904-5035
- **Mailing address:** 1460 S MCCALL RD, ENGLEWOOD, FL 34223-4864

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/16/2026
- **Last updated:** 04/16/2026