Provider Demographics
NPI:1952703332
Name:MEDICAL SOLUTIONS CONSULTANTS LLC
Entity Type:Organization
Organization Name:MEDICAL SOLUTIONS CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHACKO
Authorized Official - Middle Name:I
Authorized Official - Last Name:NEBU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-744-4133
Mailing Address - Street 1:7025 OLEANDER AVE.
Mailing Address - Street 2:
Mailing Address - City:PORT ST. LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-9028
Mailing Address - Country:US
Mailing Address - Phone:609-744-4133
Mailing Address - Fax:772-365-0456
Practice Address - Street 1:7025 OLEANDER AVE.
Practice Address - Street 2:
Practice Address - City:PORT ST. LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-9028
Practice Address - Country:US
Practice Address - Phone:609-744-4133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-17
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No251F00000XAgenciesHome InfusionGroup - Multi-Specialty
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion TherapyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015291000Medicaid