Provider Demographics
NPI:1841541216
Name:MEDICAL MOBILE ASSOCIATES LLC
Entity type:Organization
Organization Name:MEDICAL MOBILE ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGMR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:J
Authorized Official - Last Name:DICAPUA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-586-8058
Mailing Address - Street 1:2301 NW 33RD CT
Mailing Address - Street 2:SUITE 111
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33069-1000
Mailing Address - Country:US
Mailing Address - Phone:954-586-8058
Mailing Address - Fax:
Practice Address - Street 1:2706 NSR 7
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063
Practice Address - Country:US
Practice Address - Phone:954-586-8058
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-26
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty