Healthcare Provider Details

I. General information

NPI: 1255852471
Provider Name (Legal Business Name): ST VINCENT'S URGENT CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2017
Last Update Date: 06/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 COUNTRY ROAD 210 WEST
ST AUGUSTINE FL
32092
US

IV. Provider business mailing address

4205 BELFORT RD STE 4015
JACKSONVILLE FL
32216-3623
US

V. Phone/Fax

Practice location:
  • Phone: 904-450-6014
  • Fax: 904-450-6015
Mailing address:
  • Phone: 904-450-6014
  • Fax: 904-450-6015

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: DR. ESTRELLITA REDMON
Title or Position: PRESIDENT
Credential: MD, MBA
Phone: 904-296-4368