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General NPI Number Information
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NPI Number | 1740792126
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Entity Type | Organization
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Legal Business Name | MY MD URGENT CARE LLC
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Dates
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Enumeration Date | 10/25/2017
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Last Update Date | 04/11/2018
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Provider Practice Location Address
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Address Line | 9834 GLADES RD STE C5
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City | BOCA RATON
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State | FL
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Zip | 33434-3981
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Country | US
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Telephone | 305-761-3500
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Fax |
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Provider Business Mailing Address
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Address Line | 1521 ALTON RD # 301
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City | MIAMI BEACH
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State | FL
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Zip | 33139-3301
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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 | MANAGER
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Name | SHAY KOSTINER
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Credential |
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Telephone | 305-761-3500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice 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 | 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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