Mohib Medical LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

MOHIB MEDICAL LLC

Practice address

410 Lionel Way Ste 200
Davenport, FL 33837-7809

Phone

(863) 353-2602

NPI assigned

May 22, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Mark Nicole

Title

Manager

Phone

(321) 223-4470

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 3

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

• Osama Al-Suleiman, MD

  • Interventional Cardiology Physician
  • Clermont, FL
  • NPI 1770586026
  NPD (past)
• Stephanie Ann McDermott, ARNP

  • Family Nurse Practitioner
  • Apopka, FL
  • NPI 1962691717
  NPD (past)
• Stacey Rivera, ARNP

  • Adult Health Nurse Practitioner
  • Orlando, FL
  • NPI 1922497601

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1495411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1495411200000",
    "number": "1871020842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 LIONEL WAY STE 200",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338377809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 LIONEL WAY STE 200",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338377809",
            "telephone_number": "863-353-2602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOHIB MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-22",
        "last_updated": "2017-05-22",
        "status": "A",
        "authorized_official_last_name": "NICOLE",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "321-223-4470",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME105262",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "266607300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mighty Wings Companion Caregiver LLC
• Samikia Cleosha Mike
• Lusbelys Millan
• Allison Faye Mills, DNP, NP-C
• Patina Mills
• Saiyed Aonali Mohib, MD
• Rodsie Moise
• Jose Antonio Molero, P.A.
• Jessie Montalto, RD, LDN
• Michalina Giovanna Montalto

• Clinic/Center in Davenport, FL
• Providers in Davenport, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2017; 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.