Provider Demographics
NPI:1962927723
Name:MOBILE MEDICAL CARE
Entity type:Organization
Organization Name:MOBILE MEDICAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CRONK
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:813-833-3011
Mailing Address - Street 1:11671 DECLARATION DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33635-6338
Mailing Address - Country:US
Mailing Address - Phone:813-833-3011
Mailing Address - Fax:813-701-9056
Practice Address - Street 1:11671 DECLARATION DRIVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33635
Practice Address - Country:US
Practice Address - Phone:813-833-3011
Practice Address - Fax:813-701-9056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9305606363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty