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General NPI Number Information
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NPI Number | 1285735605
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Entity Type | Organization
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Legal Business Name | MEDFAST URGENT CARE CENTERS LLC
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 12/13/2023
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Provider Practice Location Address
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Address Line | 7925 N WICKHAM RD
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City | MELBOURNE
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State | FL
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Zip | 32940-8211
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Country | US
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Telephone | 321-409-9443
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Fax |
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Provider Business Mailing Address
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Address Line | 7925 N WICKHAM RD
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City | MELBOURNE
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State | FL
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Zip | 32940-8211
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Country | US
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Telephone | 321-751-7222
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DAVID WILLIAMS
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Credential | DO
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Telephone | 321-751-7222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | OS6588
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License Number State | FL
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