Provider Demographics
NPI:1750156287
Name:GRACE MOBILE HEALTHCARE SOLUTIONS LLC
Entity type:Organization
Organization Name:GRACE MOBILE HEALTHCARE SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MIRDINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MINVIEL
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:954-822-9322
Mailing Address - Street 1:4787 NW 72ND PL
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-2741
Mailing Address - Country:US
Mailing Address - Phone:954-822-9322
Mailing Address - Fax:
Practice Address - Street 1:9825 MARINA BLVD STE 100
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-6628
Practice Address - Country:US
Practice Address - Phone:848-256-0360
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-15
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty