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Organization

NURSE PRACTITIONER GROUP LLC

Active
Other names
The Nurse Practitioner Group LLC, My Mobile Primary Health Care, LLC
Organization subpart
No

Provider details

NPI number
Authorized official
STACEY SANTIAGO (OWNER)
(256) 508-9034
Entity
Organization

Contact information

Practice address
12380 NW 9TH ST, PLANTATION, FL 33325-1305
(256) 508-9034
Mailing address
12380 NW 9TH ST, PLANTATION, FL 33325-1305

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
ARNP9224482
FL
363LX0106X
Occupational Health Nurse Practitioner
R185090
MD

Other

Enumeration date
01/23/2017
Last updated
07/21/2020
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