MEDICARE: MEDIX URGENT CARE CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QU0200X	Urgent Care Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114236676
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDIX URGENT CARE CENTER LLC

Provider Business Mailing Address
First Line	:	2331 N STATE ROAD 7 STE 102
Second Line	:
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33313-3771
Country	:	US
Telephone Number	:	954-530-4355
Fax Number	:	954-530-4355

Provider Business Practice Location Address
First Line	:	2331 N STATE ROAD 7 STE 102
Second Line	:
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33313-3771
Country	:	US
Telephone Number	:	954-530-4355
Fax Number	:	954-530-4355

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. YVETTE J FLETCHER
Credential	:	ARNP
Telephone Number	:	954-530-4355

Provider Enumeration Date	:	10/01/2010
Last Update Date	:	02/20/2024

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