Provider Demographics
NPI:1770159808
Name:MED BOSS CONSULTING LLC
Entity type:Organization
Organization Name:MED BOSS CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-258-1477
Mailing Address - Street 1:10641 WINDSMONT CT
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33936-7268
Mailing Address - Country:US
Mailing Address - Phone:239-258-1477
Mailing Address - Fax:844-442-8248
Practice Address - Street 1:99-149 MOANALUA RD STE 201
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4001
Practice Address - Country:US
Practice Address - Phone:808-468-2439
Practice Address - Fax:844-442-8248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-30
Last Update Date:2021-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty