Organization
MOBILE MEDICAL OPERATING COMPANY LLC
Active
Other names
Mobile Medical
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT YOUNG (SECRETARY & CAO)
(904) 733-1003
Entity
Organization
Contact information
Practice address
1840 SE PORT ST LUCIE BLVD STE 1840, PORT ST LUCIE, FL 34952-5545
(772) 221-7620
(772) 221-9903
Mailing address
4655 SALISBURY RD STE 110, JACKSONVILLE, FL 32256-0957
(904) 733-1003
(904) 448-8855
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
208D00000X
General Practice Physician
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117201700
—
FL
01
—
13404
AHCA
FL
Enumeration date
02/01/2022
Last updated
09/25/2024
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