Provider Demographics
NPI:1306290770
Name:MOBILE DOCTORS 365
Entity type:Organization
Organization Name:MOBILE DOCTORS 365
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEJANDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-947-3823
Mailing Address - Street 1:8736 W COMMERCIAL BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-4378
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8736 W COMMERCIAL BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-4378
Practice Address - Country:US
Practice Address - Phone:954-947-3823
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-21
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty