Organization Name: | OCEAN MEDICAL WALK-IN CLINIC |
NPI Number: | 1184046393 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LUIS G RODAS (PRESIDENT) |
Mailing Address: | 4001 N Ocean Dr Ste 105 Lauderdale By The Sea |
State: | FL US |
Postal Code: | 333085968 |
Phone Number: | 9547714000 |
Fax Number: | |
NPI Enumeration Date: | 01/08/2014 |
NPI Last Update Date: | 01/08/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 364SF0001X |
License Number: | 9100841 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Clinical Nurse Specialist |
Taxonomy Specialization: | Family Health |
Taxonomy Definition: |