Provider Demographics
NPI:1336145119
Name:AMERICAN MEDICAL MOBILITY LLC
Entity Type:Organization
Organization Name:AMERICAN MEDICAL MOBILITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:GANN
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-331-6565
Mailing Address - Street 1:3716 NW 97TH BLVD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-5065
Mailing Address - Country:US
Mailing Address - Phone:352-331-6565
Mailing Address - Fax:352-331-6595
Practice Address - Street 1:3716 NW 97TH BLVD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-5065
Practice Address - Country:US
Practice Address - Phone:352-331-6565
Practice Address - Fax:352-331-6595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1717332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLR9320OtherBLUECROSSBLUESHIELD NUMBE
FL4506890001Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER