| Organization Name: | MEDFAST URGENT CARE CENTERS, LLC |
| NPI Number: | 1730405820 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAVID T WILLIAMS (MANAGING MEMBER) |
| Mailing Address: | 5005 Port St John Pkwy Port St John |
| State: | FL US |
| Postal Code: | 329274305 |
| Phone Number: | 3217517222 |
| Fax Number: | 3217516655 |
| NPI Enumeration Date: | 04/14/2010 |
| NPI Last Update Date: | 01/25/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QU0200X |
| License Number: | OS6588 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Urgent Care |
| Taxonomy Definition: | |