Provider Demographics
NPI:1083828511
Name:M P MEDICAL SERVICES, INC.
Entity Type:Organization
Organization Name:M P MEDICAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:LOVELL
Authorized Official - Suffix:
Authorized Official - Credentials:CH 5345
Authorized Official - Phone:239-541-0005
Mailing Address - Street 1:PO BOX 150250
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33915-0250
Mailing Address - Country:US
Mailing Address - Phone:239-541-0005
Mailing Address - Fax:239-541-0007
Practice Address - Street 1:3724 DEL PRADO BLVD S STE 5
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-7173
Practice Address - Country:US
Practice Address - Phone:239-541-0005
Practice Address - Fax:239-541-0007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 5345111N00000X
FL363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Not Answered363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty