# QUICK CARE MED, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** QUICK CARE MED LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1962060939
- **Legal business name:** QUICK CARE MED LLC
- **Authorized official:** JEANETTE SMITH (CREDENTIALING MANAGER)
- **Authorized official phone:** (352) 634-8736

## Contact information

- **Practice address:** 517 W NOBLE AVE, WILLISTON, FL 32696
- **Practice address phone:** (352) 528-9355
- **Practice address fax:** (352) 528-7427
- **Mailing address:** PO BOX 2066, LECANTO, FL 34460-2066
- **Mailing address phone:** (352) 563-0931
- **Mailing address fax:** (352) 563-0935

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |
| 332900000X | Non-Pharmacy Dispensing Site | — | — | — |

## Other

- **Enumeration date:** 06/04/2019
- **Last updated:** 06/24/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 003672406 | — | FL |