Healthcare Provider Details

I. General information

NPI: 1124469697
Provider Name (Legal Business Name): IMMEDIATE HEALTH CARE CENTERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2013
Last Update Date: 07/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 E HALLANDALE BEACH BLVD SUITE T
HALLANDALE BEACH FL
33009-4834
US

IV. Provider business mailing address

2500 E HALLANDALE BEACH BLVD SUITE T
HALLANDALE BEACH FL
33009-4834
US

V. Phone/Fax

Practice location:
  • Phone: 954-457-4800
  • Fax:
Mailing address:
  • Phone: 954-457-4800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License NumberME32051
License Number StateFL

VIII. Authorized Official

Name: MICHEL F JACQUES
Title or Position: OWNER
Credential:
Phone: 954-457-4800