Provider Demographics
NPI:1811789746
Name:MOBILE INFUSION RN LLC
Entity type:Organization
Organization Name:MOBILE INFUSION RN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:R
Authorized Official - Last Name:RENFORT
Authorized Official - Suffix:JR
Authorized Official - Credentials:RN
Authorized Official - Phone:407-837-2613
Mailing Address - Street 1:332 AVE BSW
Mailing Address - Street 2:200-31
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33880
Mailing Address - Country:US
Mailing Address - Phone:407-837-2613
Mailing Address - Fax:407-887-9521
Practice Address - Street 1:332 AVE BSW
Practice Address - Street 2:200-31
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880
Practice Address - Country:US
Practice Address - Phone:407-837-2613
Practice Address - Fax:407-887-9521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion