A Mobile Healthcare LLC
Organization Active NPI Nurse Practitioner · Holmes Beach, FL
NPI 1417475013 · NPPES record last updated Nov 25, 2019
Key facts
- NPI
- 1417475013
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nurse Practitioner 363L00000X
- Legal business name
- A MOBILE HEALTHCARE LLC
- Practice address
- 209 82ND Street
Holmes Beach, FL 34217 - Phone
- (941) 545-1296
- Fax
- (941) 209-5653
- NPI assigned
- Sep 3, 2017
- Organization subpart
- No
Authorized official
- Name
- Andrea Nicholas, ARNP
- Title
- President
- Phone
- (941) 999-2560
Practitioners 1
-
Andrea Nicholas, ARNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20171218003184 | FL | Part B Supplier - Clinic/Group Practice | 8527326685 |
Receives reassigned benefits from 1 practitioner Practice locations: Bradenton, FL |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner |
363L00000X | Yes |
Addresses
Primary practice location
209 82ND Street
Holmes Beach, FL 34217
Mailing address
PO Box 14669
Bradenton, FL 34280
Phone (941) 545-1296
Other providers in Holmes Beach, FL
- Ami Occupational Therapy and Wellness
- Anna Maria Island Dental Inc.
- Paul Joseph Barrese
- Claudia J Carlson
- Joseph John Catera
All providers in Holmes Beach, FL · Nurse Practitioner in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 25, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.