Healthcare Provider Details

I. General information

NPI: 1821377201
Provider Name (Legal Business Name): URGENT CARE PHYSICIANS OF KENDALE LAKES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2011
Last Update Date: 08/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14661 SW 56 STREET
MIAMI FL
33175
US

IV. Provider business mailing address

8780 SW 92ND ST SUITE 200
MIAMI FL
33176-2461
US

V. Phone/Fax

Practice location:
  • Phone: 786-457-5261
  • Fax: 305-554-4828
Mailing address:
  • Phone: 786-457-5261
  • Fax: 305-554-4828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID R NATEMAN
Title or Position: OWNER
Credential: MD
Phone: 786-457-5261