Provider Demographics
NPI:1396093365
Name:SENIOR MOBILE CARE,INC.
Entity type:Organization
Organization Name:SENIOR MOBILE CARE,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:M
Authorized Official - Last Name:GREER
Authorized Official - Suffix:
Authorized Official - Credentials:DNP,ARNP-C
Authorized Official - Phone:352-476-4879
Mailing Address - Street 1:6070 E QUINCY ST
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34452-7917
Mailing Address - Country:US
Mailing Address - Phone:352-476-4879
Mailing Address - Fax:352-419-4713
Practice Address - Street 1:6070 E QUINCY ST
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34452-7917
Practice Address - Country:US
Practice Address - Phone:352-476-4879
Practice Address - Fax:352-419-4713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-26
Last Update Date:2012-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3075592363LF0000X
FL2510462363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1932215662Medicare UPIN
FL1780607846Medicare UPIN