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Organization
THSE - MARCO URGENT CARE LLC
Active
Organization
THSE - MARCO URGENT CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL D CORVINI MD (PRESIDENT)
(800) 424-3672
Entity
Organization
Contact information
Practice address
40 S HEATHWOOD DR, MARCO ISLAND, FL 34145-5026
(239) 394-8234
Mailing address
1643 NW 136TH AVE STE 100, SUNRISE, FL 33323-2857
(800) 424-3672
(954) 377-3042
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000JT
BLUE CROSS FL
FL
05
—
002393100
—
FL
Enumeration date
12/11/2009
Last updated
09/29/2020
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