Organization
YOUR FAMILY WALK-IN CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA BRUNTON APRN (OWNER)
(813) 792-8555
Entity
Organization
Contact information
Practice address
17929 HUNTING BOW CIR, LUTZ, FL 33558-5378
(813) 792-8555
Mailing address
17929 HUNTING BOW CIR, LUTZ, FL 33558-5378
(727) 580-9131
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
2776972
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154368883
MEDICARE PTAN
FL
05
—
302641800
—
FL
Enumeration date
01/05/2014
Last updated
08/02/2024
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