Healthcare Provider Details

I. General information

NPI: 1639905284
Provider Name (Legal Business Name): PLANTATION URGENT CARE CENTERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2024
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 W BROWARD BLVD STE 101
FORT LAUDERDALE FL
33312-1018
US

IV. Provider business mailing address

3800 W BROWARD BLVD STE 101
FORT LAUDERDALE FL
33312-1018
US

V. Phone/Fax

Practice location:
  • Phone: 954-440-0983
  • Fax:
Mailing address:
  • Phone: 954-440-0983
  • 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: AL BERRY
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 469-915-4211