Provider Demographics
NPI:1316604283
Name:MOBILE URODYNAMICS HEALTH PLUS LLC
Entity type:Organization
Organization Name:MOBILE URODYNAMICS HEALTH PLUS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARBELYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:NERETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-990-9407
Mailing Address - Street 1:2426 MERIDITH DRIVE
Mailing Address - Street 2:
Mailing Address - City:LONGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:33052-3892
Mailing Address - Country:US
Mailing Address - Phone:877-844-9005
Mailing Address - Fax:
Practice Address - Street 1:5900 HILLANDALE DR STE 325
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058-3892
Practice Address - Country:US
Practice Address - Phone:877-844-9005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-26
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty