Healthcare Provider Details

I. General information

NPI: 1508840208
Provider Name (Legal Business Name): TEQUESTA URGENT CARE, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MAIN ST SUITE 102
TEQUESTA FL
33469-4709
US

IV. Provider business mailing address

1 MAIN ST SUITE 102
TEQUESTA FL
33469-4709
US

V. Phone/Fax

Practice location:
  • Phone: 561-747-4464
  • Fax: 561-747-5598
Mailing address:
  • Phone: 561-747-4464
  • Fax: 561-747-5598

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberHCC5420
License Number StateFL

VIII. Authorized Official

Name: FRANCINE GRECO
Title or Position: PARTNER
Credential: D.O.
Phone: 561-747-4464