=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003353020
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PRONTO URGENT CARE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/28/2017
-----------------------------------------------------
Last Update Date | 07/16/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2633 E COMMERCIAL BLVD SUITE C
-----------------------------------------------------
City | FORT LAUDERDALE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33308-4135
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-790-1718
-----------------------------------------------------
Fax | 954-909-5709
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2500 E COMMERCIAL BLVD STE D
-----------------------------------------------------
City | FORT LAUDERDALE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33308-4124
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-909-5708
-----------------------------------------------------
Fax | 954-909-5709
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEDICAL DOCTOR
-----------------------------------------------------
Name | DR. MARIA BELEN GAME
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 954-909-5708
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QU0200X
-----------------------------------------------------
Taxonomy Name | Urgent Care Clinic/Center
-----------------------------------------------------
License Number | 100292
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------