Healthcare Provider Details

I. General information

NPI: 1033804661
Provider Name (Legal Business Name): QUICK CARE MED, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2023
Last Update Date: 04/11/2023
Certification Date: 04/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1907 HIGHWAY 44 W
INVERNESS FL
34453-3801
US

IV. Provider business mailing address

PO BOX 2066
LECANTO FL
34460-2066
US

V. Phone/Fax

Practice location:
  • Phone: 844-797-8425
  • Fax:
Mailing address:
  • Phone: 844-797-8425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHARLEY MARIE BALBUENA
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 352-513-9265