Provider Demographics
NPI:1083349971
Name:MBA MEDICAL CONCEPTS, INC
Entity Type:Organization
Organization Name:MBA MEDICAL CONCEPTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDSON
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-959-4314
Mailing Address - Street 1:5700 LAKE WORTH RD STE 310-1
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-3202
Mailing Address - Country:US
Mailing Address - Phone:800-959-4314
Mailing Address - Fax:561-600-4432
Practice Address - Street 1:5700 LAKE WORTH RD STE 310-1
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-3202
Practice Address - Country:US
Practice Address - Phone:800-959-4314
Practice Address - Fax:561-600-4432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-24
Last Update Date:2022-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies