Organization Name: | QWIKCARE INC |
NPI Number: | 1578991782 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | VENUS VALLIERE (PRESIDENT) |
Mailing Address: | 4721 E Moody Blvd Suite 204 Bunnell |
State: | FL US |
Postal Code: | 321107705 |
Phone Number: | 3868640791 |
Fax Number: | |
NPI Enumeration Date: | 10/25/2013 |
NPI Last Update Date: | 10/25/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | ARNP9265125 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |