Healthcare Provider Details

I. General information

NPI: 1609097674
Provider Name (Legal Business Name): QUICKCARE OF CAPE CORAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 CAPE CORAL PKWY E
CAPE CORAL FL
33904-8545
US

IV. Provider business mailing address

515 CAPE CORAL PKWY E
CAPE CORAL FL
33904-8545
US

V. Phone/Fax

Practice location:
  • Phone: 239-549-2772
  • Fax: 239-549-2332
Mailing address:
  • Phone: 239-549-2772
  • Fax: 239-549-2332

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: ALAN L TANNENBAUM
Title or Position: OWNER MED DIR
Credential: MD
Phone: 239-549-2772