Southeast Mobility Group, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

3122337 Issued in FL

Legal business name

SOUTHEAST MOBILITY GROUP, LLC

Practice address

615 S Yonge St
Ormond Beach, FL 32174-7541

Phone

(386) 673-6902

Fax

(386) 673-6976

NPI assigned

Oct 10, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Craig A Daley

Title

Managing Member/President

Phone

(386) 673-6902

Specialties & licenses 1

Addresses

Other names 1

• Scooters Unlimited Doing business as

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952399453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 S YONGE ST",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321747541",
            "telephone_number": "386-673-6902",
            "fax_number": "386-673-6976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 S YONGE ST",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321747541",
            "telephone_number": "386-673-6902",
            "fax_number": "386-673-6976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST MOBILITY GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DALEY",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGING MEMBER/PRESIDENT",
        "authorized_official_telephone_number": "386-673-6902",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "FL",
            "license": "3122337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Scooters Unlimited",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• Durable Medical Equipment & Medical Supplies in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.