Mac Innovation
Clinic/Center, Multi-Specialty in Englewood, FL. Organization (NPI-2).
NPI number1619811056
StatusActive
Last updated in NPPESApr 16, 2026
Details
- NPI
- 1619811056
- Entity type
- Organization (NPI-2)
- Legal business name
- Mac Innovation
- Organization subpart
- No
- Enumeration date
- Apr 16, 2026
- Certification date
- Apr 16, 2026
- Last updated
- Apr 16, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM1300X | Clinic/Center, Multi-Specialty | – | – | Yes |
Practice location
1460 S McCall Rd Ste 1aEnglewood, FL 34223-4824
Phone 520-904-5035
Mailing address
1460 S McCall RdEnglewood, FL 34223-4864
Authorized official
Cassandra Sylvia Young
Ceo
5209045035
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