Organization
MOBILE VISITING PRACTITIONERS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD R KOP (DIRECTOR OF OPERATIONS)
(352) 362-0627
Entity
Organization
Contact information
Practice address
140 S BEACH ST STE 202, DAYTONA BEACH, FL 32114-4409
(888) 506-8836
(888) 506-8837
Mailing address
140 S BEACH ST STE 202, DAYTONA BEACH, FL 32114-4409
(888) 506-8836
(888) 506-8837
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/13/2018
Last updated
11/05/2020
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