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Organization
PRUDENTIAL URGENT CARE & DIAGNOSTIC, INC.
Active
Organization
PRUDENTIAL URGENT CARE & DIAGNOSTIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLLIE ROYSTER (MANAGER)
(954) 530-9280
Entity
Organization
Contact information
Practice address
4101 NW 3RD CT, SUITE 3, PLANTATION, FL 33317-2857
(954) 530-9280
(954) 533-1024
Mailing address
4101 NW 3RD CT, SUITE 3, PLANTATION, FL 33317-2857
(954) 530-9280
(954) 533-1024
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
OS1505
FL
208D00000X
General Practice Physician
ME79405
FL
261QU0200X
Urgent Care Clinic/Center
Primary
OS1505
FL
Other
Enumeration date
08/06/2015
Last updated
02/27/2017
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