Mack and Bedford Consulting and Supportive

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

6906334 Issued in FL

Legal business name

MACK AND BEDFORD CONSULTING AND SUPPORTIVE

Practice address

7512 Oxford Garden Cir
Apollo Beach, FL 33572-1730

Phone

(813) 965-6914

Fax

(786) 219-3284

NPI assigned

Jun 12, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Jerald Mack Sr., B.A.

Title

Owner / Ceo

Phone

(813) 965-6914

Specialties & licenses 1

Addresses

Other names 1

• Jerald Mack SR Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1244764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244764800000",
    "number": "1285861591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7512 OXFORD GARDEN CIR",
            "city": "APOLLO BEACH",
            "state": "FL",
            "postal_code": "335721730",
            "telephone_number": "813-965-6914",
            "fax_number": "786-219-3284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7512 OXFORD GARDEN CIR",
            "city": "APOLLO BEACH",
            "state": "FL",
            "postal_code": "335721730",
            "telephone_number": "813-965-6914",
            "fax_number": "786-219-3284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACK AND BEDFORD CONSULTING AND SUPPORTIVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-12",
        "last_updated": "2009-06-12",
        "status": "A",
        "authorized_official_last_name": "MACK",
        "authorized_official_first_name": "JERALD",
        "authorized_official_title_or_position": "OWNER / CEO",
        "authorized_official_telephone_number": "813-965-6914",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "B.A."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "FL",
            "license": "6906334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jerald Mack SR",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Skylar Long, PA-C
• Luis Eric Lopez
• Sydney Lundy, DMD
• Luxehealth Florida LLC
• Morgan Nance Lycett
• Raymond Eric Major, MD
• Gianna Malcolm-Lavalais
• Stephanie Hires Malik, FNP-C
• Joshua Smith Martin, L.M.T. P.T.A
• Aubi Martinez

• Adult Care Home Facility in Apollo Beach, FL
• Providers in Apollo Beach, FL by specialty
• Adult Care Home Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.