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General NPI Number Information
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NPI Number | 1164967543
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Entity Type | Organization
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Legal Business Name | WRMCABNS, LLC
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Dates
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Enumeration Date | 12/21/2016
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Last Update Date | 04/24/2020
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Provider Practice Location Address
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Address Line | 3319 S STATE ROAD 7 STE 102
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City | WELLINGTON
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State | FL
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Zip | 33449-8099
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Country | US
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Telephone | 561-333-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 367 S GULPH RD
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City | KING OF PRUSSIA
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State | PA
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Zip | 19406-3121
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VP
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Name | MR. TODD EVANS
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Credential |
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Telephone | 610-768-3300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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