Healthcare Provider Details

I. General information

NPI: 1902092950
Provider Name (Legal Business Name): PDQ CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2007
Last Update Date: 05/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10300 W FOREST HILL BLVD SPACE 177
WELLINGTON FL
33414-3120
US

IV. Provider business mailing address

3130 NW 111TH AVE
CORAL SPRINGS FL
33065-3534
US

V. Phone/Fax

Practice location:
  • Phone: 561-793-1336
  • Fax: 561-753-0075
Mailing address:
  • Phone: 954-341-9381
  • Fax: 954-341-0641

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberPENDING
License Number StateFL

VIII. Authorized Official

Name: MR. REID C BECKER
Title or Position: CEO/PRESIDENT
Credential:
Phone: 954-341-9381