MEDICARE: MED FIRST URGENT CARE CENTERS, INC

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	207QA0505X	Adult Medicine Physician	ME64301	FL

General Provider Information

NPI Number	:	1700219888
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MED FIRST URGENT CARE CENTERS, INC

Provider Business Mailing Address
First Line	:	PO BOX 8256
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33482-8256
Country	:	US
Telephone Number	:	561-279-2722
Fax Number	:	561-279-2522

Provider Business Practice Location Address
First Line	:	900 E ATLANTIC AVE
Second Line	:	SUITE # 9
City	:	DELRAY BEACH
State	:	FL
Zip	:	33483-6954
Country	:	US
Telephone Number	:	561-279-2722
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. NANCY E. DEJESUS
Credential	:	MD
Telephone Number	:	561-279-2722

Provider Enumeration Date	:	08/13/2013
Last Update Date	:	08/13/2013

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