Mos Llc

NPI 1194701862 - Nurse Practitioner - 363LA2200X

NPI Details
NPI 1194701862
Enumeration Date 12/15/2005
Last Updated 07/31/2013
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name TAMMY TAMMY
Position OWNER
Phone (850) 973-4590
Fax (850) 973-4929
Practice Location
256 SW WASHINGTON AVE
MADISON FL, 32340, US
Phone (850) 973-4590
Fax (850) 973-4929
Business Location
PO BOX 902
MADISON FL, 32341, US
Phone (850) 973-4590
Fax (850) 973-4929
Toxanomy
Taxonomy Code 363LA2200X
License State Florida
License Number 1396122
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According to our database, Mos Llc NPI is 1194701862, taxonomy code is 363LA2200X and license number is 1396122, license state is located at Florida. Mos Llc physically located at 256 Sw Washington Ave, Madison FL, 32340. NPI Number 1033115704 has the healthcare provider type.

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1194701862 NPI number is provided on an as is basis without warranty of any kind. 1194701862 is maintained by the National Plan & Provider Enumeration System. The contents of Mos Llc are for informational purposes only.