Healthcare Provider Details

I. General information

NPI: 1568990208
Provider Name (Legal Business Name): FIRST CHOICE URGENT MEDCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2017
Last Update Date: 05/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 S PONCE DE LEON BLVD
ST AUGUSTINE FL
32084-4278
US

IV. Provider business mailing address

6160 SW HIGHWAY 200 # 119
OCALA FL
34476-8307
US

V. Phone/Fax

Practice location:
  • Phone: 352-694-6331
  • Fax: 352-694-6338
Mailing address:
  • Phone: 352-694-6331
  • Fax: 352-694-6338

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. EDWARD LUCAS
Title or Position: OWNER/CEO
Credential: MD
Phone: 352-255-7777