PHYSICIANS IMMEDIATE CARE (NPI# 1952572430) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952572430 |
| Entity Type | Organization |
| Organization Name | PHYSICIANS IMMEDIATE CARE |
| Practice Address |
4007 Sw Port St Lucie Blvd Suite #12 Port St Lucie FL 34953-5679 |
| Mailing Address |
3607 Old Conejo Rd Thousand Oaks CA 91320-2123 |
| Practice Telephone | 7723431774 |
| Practice Fax Number | 7723431744 |
| Mailing Telephone | 8053750800 |
| Enumeration Date | 2008-03-12 |
| Last Update Date | 2008-03-12 |
| Authorized Official Name | KENNETH J PALESTRANT (PHYSICIAN) |
| Authorized Official Telephone | 7723431774 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | FP0126222 | FL | Suppliers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | PHYSICIANS IMMEDIATE CARE & MEDICAL CENTERS, P.S. | 310 Torbett St, Richland, WA 99354-2604 |
| System for Award Management (SAM) Entities | PHYSICIANS IMMEDIATE CARE LLC | 9701 W Higgins Rd Ste 270, Rosemont, IL 60018-4703 |
| Oklahoma Business Registrations | PHYSICIANS IMMEDIATE CARE LLC | 1209 Orange St, Wilmington, DE 19801 |
| Street Address |
4007 SW PORT ST LUCIE BLVD SUITE #12 |
| City | PORT ST LUCIE |
| State | FL |
| Zip Code | 34953-5679 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063808301 | Physicians Immediate Care Southwest, LLC | Clinic/Center | 4007 Sw Port St Lucie Blvd, Port St Lucie, FL 34953-5679 | 2015-04-14 |
| 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 | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467811430 | Medical Consultants of Florida LLC | Non-Pharmacy Dispensing Site | 672 Sw Prima Vsta Blvd, 101, Port St Lucie, FL 34983-1820 | 2016-02-18 |
| 1467904128 | Green Health and Wellness, LLC | Non-Pharmacy Dispensing Site | 160 Nw Central Park Plz, Ste. 110, Port St Lucie, FL 34986-1825 | 2016-10-28 |
| 1407938293 | Accurate Medical Pain and Rehab Centers | Non-Pharmacy Dispensing Site | 1701 Se Hillmoor Dr, Ste A 1, Port St Lucie, FL 34952-7552 | 2006-10-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821699232 | Orlando Dermatology Clinic LLC | Non-Pharmacy Dispensing Site | 118 W Orange St, Altamonte Springs, FL 32714-2537 | 2020-11-03 |
| 1447857339 | Chen Neighborhood Medical Centers of South Florida, LLC | Non-Pharmacy Dispensing Site | 2445 Nw 62nd St, Miami, FL 33147-7740 | 2020-10-05 |
| 1437765823 | South Miami Hospital, Inc | Non-Pharmacy Dispensing Site | 1228 S Pine Island Rd Ste 110, Plantation, FL 33324-4402 | 2020-09-21 |
| 1407460223 | Daisy Lomadilla Boyer | Non-Pharmacy Dispensing Site | 11703 Holly Creek Dr, Riverview, FL 33569-3356 | 2020-08-31 |
| 1760091078 | West Kendall Baptist Hospital, Inc. | Non-Pharmacy Dispensing Site | 14591 Sw 26th St, Miami, FL 33175-8038 | 2020-07-23 |
| 1821615436 | South Miami Hospital, Inc | Non-Pharmacy Dispensing Site | 8400 Nw 53rd St Ste F106, Doral, FL 33166-4519 | 2020-06-30 |
| 1295358422 | Ezze Pharma LLC | Non-Pharmacy Dispensing Site | 3105 Nw 107th Ave Ste 400, Doral, FL 33172-2215 | 2020-05-21 |
| 1871115436 | Kempcare Inc. | Non-Pharmacy Dispensing Site | 840 Us Highway 1 Ste 435c, N Palm Beach, FL 33408-3829 | 2020-05-17 |
| 1427670595 | Orlando Dermatology Clinic, LLC | Non-Pharmacy Dispensing Site | 3261 Us Highway 441/27 Ste F1, Fruitland Park, FL 34731-4495 | 2020-05-12 |
| 1518593177 | Dedicated Senior Medical Center of Florida, LLC | Non-Pharmacy Dispensing Site | 2724 N Hiawassee Rd Ste 100, Orlando, FL 32818-3008 | 2020-03-16 |
| Find all providers with the same taxonomy | ||||
| City | PORT ST LUCIE |
| Zip Code | 34953 |
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| 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.