MEDICARE: PRI-MED WALK IN CLINIC

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	207R00000X	Internal Medicine Physician	ME-0066803	FL

General Provider Information

NPI Number	:	1639356215
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRI-MED WALK IN CLINIC

Provider Business Mailing Address
First Line	:	7200 W COMMERCIAL BLVD
Second Line	:	SUITE 201
City	:	LAUDERHILL
State	:	FL
Zip	:	33319-2148
Country	:	US
Telephone Number	:	954-572-9199
Fax Number	:

Provider Business Practice Location Address
First Line	:	7200 W COMMERCIAL BLVD
Second Line	:	SUITE 201
City	:	LAUDERHILL
State	:	FL
Zip	:	33319-2148
Country	:	US
Telephone Number	:	954-572-9199
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. PAUL MARSDEN MURRY
Credential	:	M.D.
Telephone Number	:	954-572-9199

Provider Enumeration Date	:	01/26/2008
Last Update Date	:	01/26/2008

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Directions to “PRI-MED WALK IN CLINIC ” Practice Location

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