Provider Demographics
NPI:1578312096
Name:MOBILE MEDICAL PROFESSIONALS LLC
Entity type:Organization
Organization Name:MOBILE MEDICAL PROFESSIONALS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MAURO
Authorized Official - Middle Name:
Authorized Official - Last Name:SARMIENTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD, MBA
Authorized Official - Phone:973-715-1563
Mailing Address - Street 1:11424 CUSHMAN RD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3608
Mailing Address - Country:US
Mailing Address - Phone:973-715-1563
Mailing Address - Fax:
Practice Address - Street 1:11424 CUSHMAN RD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3608
Practice Address - Country:US
Practice Address - Phone:973-715-1563
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QP2400XAmbulatory Health Care FacilitiesClinic/CenterPrison Health
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care