| Organization Name: | MOBILE WOC, LLC |
| NPI Number: | 1003287988 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ELIZABETH M LARSON (PRESIDENT) |
| Mailing Address: | 9025 Pomelo Rd W Fort Myers |
| State: | FL US |
| Postal Code: | 339673723 |
| Phone Number: | 2392653391 |
| Fax Number: | 2394253214 |
| NPI Enumeration Date: | 10/17/2015 |
| NPI Last Update Date: | 10/17/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 9227059 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |