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Organization

MOBILE PHYSICIAN SERVICES INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PETER RADICE (MEDICAL DIRECTOR)
(855) 232-0644
Entity
Organization

Contact information

Practice address
6804 CECELIA DR, NEW PORT RICHEY, FL 34653-4935
(727) 232-0644
(888) 546-0488
Mailing address
6804 CECELIA DR, NEW PORT RICHEY, FL 34653-4935
(855) 232-0644
(888) 546-0488

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
207R00000X
Internal Medicine Physician
Primary
ME0086161
FL
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
2084P0805X
Geriatric Psychiatry Physician
213ES0103X
Foot & Ankle Surgery Podiatrist
363LA2200X
Adult Health Nurse Practitioner
363LP0808X
Psychiatric/Mental Health Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000MQ
BCBS GROUP
FL
05
007870000
FL
05
0404354
OH
05
128679200
FL
01
K9757
PTAN
FL
01
K9757A
FL PTAN
FL
01
MEDICARE NPI
1003002759
FL
Enumeration date
09/17/2007
Last updated
03/23/2026
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