| Moblie Medical Van | |
|
302 W Fletcher Ave Tampa FL 33612-3415 | |
| (813) 866-0930 | |
| (813) 866-0929 |
| Full Name | Moblie Medical Van |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 302 W Fletcher Ave, Tampa, Florida |
| Authorized Official Name and Position | Sherry Hoback (PRESIDENT/CEO) |
| Authorized Official Contact | 8138660930 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Moblie Medical Van Po Box 82969 Tampa FL 33682-2969 Ph: (813) 866-0930 | Moblie Medical Van 302 W Fletcher Ave Tampa FL 33612-3415 Ph: (813) 866-0930 |
| NPI Number | 1861535379 |
|---|---|
| Provider Enumeration Date | 02/14/2007 |
| Last Update Date | 07/17/2023 |
| Certification Date | 07/17/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861535379 | NPI | - | NPPES |
| 683710701 | Other | FL | MEDICAID FEE FOR SERVICE |
| 683710700 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | () | Primary |
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