Organization
PHYSICIANS IMMEDIATE CARE SOUTHWEST, LLC
Active
Parent organization
PHYSICIANS IMMEDIATE CARE, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHYSICIANS IMMEDIATE CARE, INC
Authorized official
KENNETH PALESTRANT M.D. (CEO)
(772) 343-1776
Entity
Organization
Contact information
Practice address
4007 SW PORT ST LUCIE BLVD, PORT ST LUCIE, FL 34953-5679
(772) 343-1774
(772) 343-1744
Mailing address
4007 SW PORT ST LUCIE BLVD, PORT ST LUCIE, FL 34953-5679
(772) 343-1774
(772) 343-1744
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
HCC5630
FL
Other
Enumeration date
04/14/2015
Last updated
04/14/2015
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