Healthcare Provider Details

I. General information

NPI: 1558762005
Provider Name (Legal Business Name): JUST 4 KIDZ URGENT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2014
Last Update Date: 09/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 NW 11TH ST SUITE E202
HOMESTEAD FL
33030-4360
US

IV. Provider business mailing address

151 NW 11TH ST SUITE E202
HOMESTEAD FL
33030-4360
US

V. Phone/Fax

Practice location:
  • Phone: 786-236-2491
  • Fax:
Mailing address:
  • Phone: 786-236-2491
  • 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: MR. GERALD DEANDRE JONES
Title or Position: CEO
Credential:
Phone: 786-236-2491