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General NPI Number Information
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NPI Number | 1508202003
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Entity Type | Organization
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Legal Business Name | 441 WALK IN CLINIC LLC
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Dates
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Enumeration Date | 05/12/2013
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Last Update Date | 05/12/2013
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Provider Practice Location Address
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Address Line | 3908 S STATE ROAD 7
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City | MIRAMAR
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State | FL
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Zip | 33023-6162
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Country | US
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Telephone | 786-282-7099
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 693332
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City | MIAMI
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State | FL
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Zip | 33269-0332
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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 | MANAGING MEMBER
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Name | MR. JOHAN GAREL
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Credential | PA-C
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Telephone | 786-282-7099
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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