Healthcare Provider Details

I. General information

NPI: 1457910366
Provider Name (Legal Business Name): ERGENT CARE FLORIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2019
Last Update Date: 06/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1799 S FEDERAL HWY
BOCA RATON FL
33432-7412
US

IV. Provider business mailing address

PO BOX 24847
JACKSONVILLE FL
32241-4847
US

V. Phone/Fax

Practice location:
  • Phone: 561-347-7933
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARK CAPUTO
Title or Position: PRESIDENT
Credential: MD
Phone: 918-527-7024