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Organization
PRIMARY URGENT CARE PL
Active
Organization
PRIMARY URGENT CARE PL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEITH B. JOHNSON M.D. (OWNER)
(941) 480-0500
Entity
Organization
Contact information
Practice address
1370 E VENICE AVE, 202, VENICE, FL 34285-9082
(941) 480-0500
(941) 480-9322
Mailing address
1370 E VENICE AVE, 202, VENICE, FL 34285-9082
(941) 480-0500
(941) 480-9322
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
98726
BCBS
FL
01
—
DE0506
RR MEDICARE
FL
Enumeration date
04/19/2006
Last updated
05/24/2010
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