PHYSICIANS IMMEDIATE CARE SOUTHWEST, LLC (NPI# 1063808301) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063808301 |
| Entity Type | Organization |
| Organization Name | PHYSICIANS IMMEDIATE CARE SOUTHWEST, LLC |
| Practice Address |
4007 Sw Port St Lucie Blvd Port St Lucie FL 34953-5679 |
| Practice Telephone | 7723431774 |
| Practice Fax Number | 7723431744 |
| Mailing Telephone | 7723431774 |
| Mailing Fax Number | 7723431744 |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2015-04-14 |
| Authorized Official Name | KENNETH PALESTRANT (CEO) |
| Authorized Official Telephone | 7723431776 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | PHYSICIANS IMMEDIATE CARE, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
HCC5630 | FL | Ambulatory Health Care Facilities |
| Street Address |
4007 SW PORT ST LUCIE BLVD |
| City | PORT ST LUCIE |
| State | FL |
| Zip Code | 34953-5679 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952572430 | Physicians Immediate Care | Non-Pharmacy Dispensing Site | 4007 Sw Port St Lucie Blvd, Suite #12, Port St Lucie, FL 34953-5679 | 2008-03-12 |
| 1356676845 | Robert Kent Bogle | Surgery | 4007 Sw Port St Lucie Blvd, Port St Lucie, FL 34953-5679 | 2009-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033733720 | Paul Desantis | Optometrist | 1805 Gatlin Blvd, Port St. Lucie, FL 34953 | 2020-05-29 |
| 1174165997 | D&r Homehealthcare LLC | Technician | 1210 Southwest Santiago Avenue, Port Saint Lucie, Fl, FL 34953 | 2019-10-14 |
| 1023677630 | Physical Therapy Wellness Group | Clinic/Center | 519 Sw Nagle Place, Port Saint Lucie, FL 34953 | 2019-06-07 |
| 1063993699 | Bloom Firm, LLC | Home Health | 1714 Sw Cycle St, Port Saint Lucie, FL 34953 | 2018-08-22 |
| 1386121333 | For His Glory Alf LLC. | Assisted Living Facility | 322 Sw South Quick Circle, Port St Lucie, FL 34953 | 2018-07-23 |
| 1730670555 | Susan May Thyme | Nurse Practitioner | 1762 Sw Choate St, Port Saint Lucie, FL 34953 | 2018-05-29 |
| 1164911301 | Viven Banks | Counselor | 3581 Sw Kromrey St, Port Saint Lucie, FL 34953 | 2018-05-03 |
| 1205323441 | Katherine Monroig | Behavior Technician | 4557 Se Babylon St, Port Saint Lucie, FL 34953 | 2018-04-13 |
| 1528567583 | Roger Rene Trudel | Nurse Practitioner | 3686 Sw Carmody Street, Port St Lucie, FL 34953 | 2018-02-06 |
| 1801315502 | Metushela Nicolas | Adult Companion | 1112 Jennifer Ter, Port Saint Lucie, FL 34953 | 2017-09-13 |
| Find all providers in zip 34953 | ||||
| Taxonomy Code | 261QU0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Urgent Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063954790 | East Florida Carenow Urgent Care, LLC | Clinic/Center | 1900 Se Port St Lucie Blvd, Port St Lucie, FL 34952-5554 | 2016-11-11 |
| 1831585108 | Physicians Immediate Care East, LLC | Clinic/Center | 1900 Se Port St Lucie Blvd, Port St Lucie, FL 34952-5554 | 2015-04-13 |
| 1699160952 | Physicians Immediate Care St Lucie West, LLC | Clinic/Center | 1730 Sw Saint Lucie West Blvd, Port St Lucie, FL 34986-2504 | 2015-04-03 |
| 1851676472 | Medi-fast Urgent Care, LLC | Clinic/Center | 672 Sw Prima Vista Blvd, Suite 102, Port St Lucie, FL 34983-1835 | 2011-10-14 |
| 1295947323 | Physicians Immediate Care Inc | Clinic/Center | 1900 Se Port St Lucie Blvd, Port St Lucie, FL 34952-5554 | 2007-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710588744 | Adventist Health System/ Sunbelt, Inc. | Clinic/Center | 3708 Sw College Rd, Ocala, FL 34474-4441 | 2020-11-05 |
| 1689273187 | American Urgent Care and Walk In Clinics LLC | Clinic/Center | 601 Gray Ave, Wildwood, FL 34785-3520 | 2020-10-26 |
| 1619575529 | Medec Urgent Care Pllc | Clinic/Center | 600 Garden St, Titusville, FL 32796-3489 | 2020-10-13 |
| 1144835182 | Adventist Health System/sunbelt, Inc | Clinic/Center | 11826 State Road 54, Odessa, FL 33556-3496 | 2020-09-15 |
| 1528671096 | Crucialist LLC | Clinic/Center | 4230 Pablo Professional Ct Ste 103, Jacksonville, FL 32224-3223 | 2020-08-25 |
| 1194334961 | Md Now Medical Centers Inc | Clinic/Center | 4332 Cortez Rd W, Bradenton, FL 34210-3139 | 2020-07-28 |
| 1558970327 | Md Now Medical Centers Inc | Clinic/Center | 15165 Mcgregor Blvd, Fort Myers, FL 33908-1957 | 2020-07-28 |
| 1386253151 | Md Now Medical Centers Inc | Clinic/Center | 12748 S Cleveland Ave, Fort Myers, FL 33907-3823 | 2020-07-28 |
| 1821607698 | Md Now Medical Centers Inc | Clinic/Center | 2609 Santa Barbara Blvd, Cape Coral, FL 33914-4457 | 2020-07-28 |
| 1366051435 | Md Now Medical Centers Inc | Clinic/Center | 9690 Glades Rd Unit 425, Boca Raton, FL 33434-3978 | 2020-07-24 |
| Find all providers with the same taxonomy | ||||
| City | PORT ST LUCIE |
| Zip Code | 34953 |
Please comment or provide details below to improve the information on PHYSICIANS IMMEDIATE CARE SOUTHWEST, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.