Healthcare Provider Details

I. General information

NPI: 1194060202
Provider Name (Legal Business Name): OCEANSIDE URGENT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2012
Last Update Date: 11/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11786 SE FEDERAL HWY SUITE B
HOBE SOUND FL
33455-5303
US

IV. Provider business mailing address

11786 SE FEDERAL HWY SUITE B
HOBE SOUND FL
33455-5303
US

V. Phone/Fax

Practice location:
  • Phone: 772-546-4215
  • Fax: 772-546-8741
Mailing address:
  • Phone: 772-546-4215
  • Fax: 772-546-8741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberOS8519
License Number StateZZ

VIII. Authorized Official

Name: DR. THERESA GOEBEL
Title or Position: OWNER
Credential: DO
Phone: 772-546-4215