# MULBERRYS MOBILE PROVIDER SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mulberrys Mobile Provider Services, LLC, MMPS, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831683861
- **Authorized official:** DR. MICHELL MULBERRY DNP, APRN-BC (PROVIDER, OWNER)
- **Authorized official phone:** (352) 358-8070

## Contact information

- **Practice address:** 6435 SE US HIGHWAY 301, HAWTHORNE, FL 32640-7309
- **Practice address phone:** (352) 358-8070
- **Practice address fax:** (949) 577-4783
- **Mailing address:** 6435 SE US HIGHWAY 301, HAWTHORNE, FL 32640-7309
- **Mailing address phone:** (352) 358-8070
- **Mailing address fax:** (949) 577-4783

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 06/22/2018
- **Last updated:** 02/08/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 106245700 | — | FL |
| 05 | — | 107001000 | — | FL |