Provider Demographics
NPI:1851020218
Name:PRIMARY CARE MOBILE SERVICES LLC
Entity Type:Organization
Organization Name:PRIMARY CARE MOBILE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHLAU
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:727-409-6040
Mailing Address - Street 1:7965 CAUSEWAY BLVD N
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33707-1007
Mailing Address - Country:US
Mailing Address - Phone:727-409-6040
Mailing Address - Fax:
Practice Address - Street 1:7965 CAUSEWAY BLVD N
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33707-1007
Practice Address - Country:US
Practice Address - Phone:727-409-6040
Practice Address - Fax:727-289-3852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty