Provider Demographics
NPI:1932974367
Name:MOBILE CARE ON DEMAND LLC
Entity Type:Organization
Organization Name:MOBILE CARE ON DEMAND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TAMIRAH
Authorized Official - Middle Name:
Authorized Official - Last Name:BONABY
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:561-714-9747
Mailing Address - Street 1:3575 WEBBER ST STE 106
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-4930
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3575 WEBBER ST STE 106
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-4930
Practice Address - Country:US
Practice Address - Phone:561-714-9747
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
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty