| Organization Name: | RUSKIN CONVENIENT MEDICAL WALK-IN |
| NPI Number: | 1023379450 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BETTY JO CARTER (PRESIDENT) |
| Mailing Address: | 1611 E Shell Point Rd Ruskin |
| State: | FL US |
| Postal Code: | 335705087 |
| Phone Number: | 8136459009 |
| Fax Number: | 8139026436 |
| NPI Enumeration Date: | 06/01/2012 |
| NPI Last Update Date: | 06/01/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QH0100X |
| License Number: | ME31419 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Health Service |
| Taxonomy Definition: | |