Healthcare Provider Details

I. General information

NPI: 1215599949
Provider Name (Legal Business Name): QUICK CARE MED, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2019
Last Update Date: 04/06/2023
Certification Date: 04/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3925 N LECANTO HWY
BEVERLY HILLS FL
34465-3507
US

IV. Provider business mailing address

PO BOX 2066
LECANTO FL
34460-2066
US

V. Phone/Fax

Practice location:
  • Phone: 352-527-7336
  • Fax: 352-513-2030
Mailing address:
  • Phone: 352-563-0931
  • Fax: 352-563-0935

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: DEAN C MAJOR
Title or Position: CRED SPEC
Credential:
Phone: 352-634-8736