Provider Demographics
NPI:1417475013
Name:A MOBILE HEALTHCARE LLC
Entity Type:Organization
Organization Name:A MOBILE HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:NICHOLAS
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:941-999-2560
Mailing Address - Street 1:PO BOX 14669
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34280
Mailing Address - Country:US
Mailing Address - Phone:941-545-1296
Mailing Address - Fax:941-761-6580
Practice Address - Street 1:209 82ND STREET
Practice Address - Street 2:
Practice Address - City:HOLMES BEACH
Practice Address - State:FL
Practice Address - Zip Code:34217
Practice Address - Country:US
Practice Address - Phone:941-545-1296
Practice Address - Fax:941-209-5653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-03
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty