Healthcare Provider Details

I. General information

NPI: 1124057955
Provider Name (Legal Business Name): PARSONS WALK IN CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 05/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1082 E BRANDON BLVD
BRANDON FL
33511-5509
US

IV. Provider business mailing address

PO BOX 3550
BRANDON FL
33509-3550
US

V. Phone/Fax

Practice location:
  • Phone: 813-689-8900
  • Fax: 813-653-9696
Mailing address:
  • Phone: 813-689-8900
  • Fax: 813-653-9696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME96113
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME98549
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME59912
License Number StateFL

VIII. Authorized Official

Name: MR. AMARJIT S. DHALIWAL
Title or Position: CEO PRESIDENT
Credential:
Phone: 813-689-8900