NPIMap

Organization Active NPI

Mobile Physicians Team LLC

  • Clinic/Center
  • Winter Haven, FL
National Provider Identifier
1609370774
Registry record updated Mar 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
MOBILE PHYSICIANS TEAM LLC
Practice address
1225 Havendale Blvd NW
Winter Haven, FL 33881-1349
Phone
(863) 298-6717
Fax
(863) 298-6719
NPI assigned
Mar 22, 2018
Organization subpart
Yes
Parent organization
MOBILE PHYSICIANS TEAM MANAGEMENT LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 22, 2018

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

Authorized official

Name
Tamara Rowland
Title
Managing Partner
Phone
(863) 298-6717

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1225 Havendale Blvd NW
Winter Haven, FL 33881-1349

Mailing address

1225 Havendale Blvd NW
Winter Haven, FL 33881-1349
Phone (863) 298-6717

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181221001110 FL Part B Supplier - Clinic/Group Practice 0345585261 Receives reassigned benefits from 7 practitioners
Practice locations: Winter Haven, FL

National Provider Directory

National Provider Directory
Part of
Mobile Physicians Team Management LLC

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1521676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521676800000",
    "number": "1609370774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 HAVENDALE BLVD NW",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338811349",
            "telephone_number": "863-298-6717",
            "fax_number": "863-298-6719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 HAVENDALE BLVD NW",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338811349",
            "telephone_number": "863-298-6717",
            "fax_number": "863-298-6719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE PHYSICIANS TEAM LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MOBILE PHYSICIANS TEAM MANAGEMENT LLC",
        "enumeration_date": "2018-03-22",
        "last_updated": "2018-03-22",
        "status": "A",
        "authorized_official_last_name": "ROWLAND",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "863-298-6717"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.