# MOBILE EKG

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1720445786
- **Authorized official:** MR. CHRISTOPHER MICHAEL RUSSELL PARAMEDIC (CEO/DIRECTOR)
- **Authorized official phone:** (941) 979-9930

## Contact information

- **Practice address:** 20281 XITA AVE, PORT CHARLOTTE, FL 33952-1234
- **Practice address phone:** (941) 979-9930
- **Mailing address:** 20281 XITA AVE, PORT CHARLOTTE, FL 33952-1234
- **Mailing address phone:** (941) 979-9930

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 95714 | PA | Yes |

## Other

- **Enumeration date:** 01/21/2016
- **Last updated:** 01/21/2016