Provider Demographics
NPI:1538401377
Name:MYCARE CLINIC
Entity type:Organization
Organization Name:MYCARE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:HOBAICA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-260-5891
Mailing Address - Street 1:4202 SILVER FOX DR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-8596
Mailing Address - Country:US
Mailing Address - Phone:239-260-5891
Mailing Address - Fax:239-260-5895
Practice Address - Street 1:6945 CARLISLE CT
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-6883
Practice Address - Country:US
Practice Address - Phone:239-260-5891
Practice Address - Fax:239-260-5895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-19
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QP2300X261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care