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Organization

PROMED WALK IN CLINIC INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CAROL LYNN JOHNS (PRESIDENT)
(863) 467-7377
Entity
Organization

Contact information

Practice address
1703 SW 2ND AVE, OKEECHOBEE, FL 34974-6169
(863) 467-7377
Mailing address
1703 SW 2ND AVE, OKEECHOBEE, FL 34974-6169
(863) 467-7377

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
ARNP3141172
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
Y9729
BLUE CROSS BLUE SHIELD FL
FL
01
Y9729Z
MEDICARE
FL
Enumeration date
11/01/2007
Last updated
11/01/2007
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