| Mohib Medical Llc | |
|
410 Lionel Way Ste 200 Davenport FL 33837-7809 | |
| (863) 353-2602 | |
| Not Available |
| Full Name | Mohib Medical Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 410 Lionel Way Ste 200, Davenport, Florida |
| Authorized Official Name and Position | Mark Nicole (MANAGER) |
| Authorized Official Contact | 3212234470 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mohib Medical Llc 410 Lionel Way Ste 200 Davenport FL 33837-7809 Ph: () - | Mohib Medical Llc 410 Lionel Way Ste 200 Davenport FL 33837-7809 Ph: (863) 353-2602 |
| NPI Number | 1871020842 |
|---|---|
| Provider Enumeration Date | 05/22/2017 |
| Last Update Date | 05/22/2017 |
| Medicare PECOS PAC ID | 0547535049 |
|---|---|
| Medicare Enrollment ID | O20171010001325 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871020842 | NPI | - | NPPES |
| ME105262 | Other | MEDICAL LICENSE | |
| 266607300 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Saiyed A Mohib |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1669486379 PECOS PAC ID: 5698714921 Enrollment ID: I20120502000728 |
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