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General NPI Number Information
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NPI Number | 1588958342
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Entity Type | Organization
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Legal Business Name | COMPLETE URGENT HEALTHCARE LLC
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Dates
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Enumeration Date | 06/08/2011
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Last Update Date | 06/08/2011
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Provider Practice Location Address
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Address Line | 2517 SEMINOLE CIR
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City | WEST PALM BEACH
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State | FL
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Zip | 33409-7460
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Country | US
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Telephone | 516-309-7815
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Fax | 516-640-9282
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Provider Business Mailing Address
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Address Line | 20665 LYONS RD #A3
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City | BOCA RATON
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State | FL
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Zip | 33434-3947
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Country | US
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Telephone | 561-309-7815
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Fax | 561-640-9282
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. EVAN GOLDSTEIN
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Credential | MD
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Telephone | 561-309-7815
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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 | ME0064033
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License Number State | FL
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