Walk-In Family Clinic LLC
Family Medicine in Orange City, FL. Organization (NPI-2).
NPI number1164021945
StatusActive
Last updated in NPPESOct 22, 2020
Details
- NPI
- 1164021945
- Entity type
- Organization (NPI-2)
- Legal business name
- Walk-In Family Clinic LLC
- Organization subpart
- No
- Enumeration date
- Oct 22, 2020
- Certification date
- Oct 22, 2020
- Last updated
- Oct 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
| 207QA0505X | Family Medicine, Adult Medicine | – | – | |
| 208D00000X | General Practice | – | – | |
| 363LF0000X | Nurse Practitioner, Family | – | – |
Practice location
926 Saxon BlvdOrange City, FL 32763-8313
Phone 386-774-1881 · Fax 386-774-1264
Mailing address
926 Saxon BlvdOrange City, FL 32763-8313
Phone 386-774-1881 · Fax 386-774-1264
Authorized official
Benjamin Weiss
Owner
3867741881
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