Provider Demographics
NPI:1528019247
Name:MOBILE MEDICAL INDUSTRIES INC
Entity Type:Organization
Organization Name:MOBILE MEDICAL INDUSTRIES INC
Other - Org Name:ALLIANCECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MAXINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOCHHAUSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-244-3601
Mailing Address - Street 1:2500 QUANTUM LAKES DR
Mailing Address - Street 2:SUITE 108
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-8324
Mailing Address - Country:US
Mailing Address - Phone:561-244-3603
Mailing Address - Fax:561-244-0222
Practice Address - Street 1:2500 QUANTUM LAKES DR
Practice Address - Street 2:SUITE 108
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-8324
Practice Address - Country:US
Practice Address - Phone:561-244-0220
Practice Address - Fax:561-244-0222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-15
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCCL 7747363A00000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001112400Medicaid
FL40576Medicare PIN
FLCG7932Medicare PIN
FL40576AMedicare PIN
FL001112400Medicaid