Organization
DWIC OF TAMPA BAY, INC
Active
Other names
MedExpress Urgent Care - Port Charlotte, Tamiami Trail
Organization subpart
No
Provider details
NPI number
Authorized official
JOY KIMBALL (CONTRACT MANAGER)
(763) 349-6740
Entity
Organization
Contact information
Practice address
2200 TAMIAMI TRL, PORT CHARLOTTE, FL 33948-2177
(941) 613-0022
(941) 613-0070
Mailing address
423 FORTRESS BLVD, MORGANTOWN, WV 26508-1351
(304) 225-2500
(304) 985-6350
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
—
—
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020259400
—
FL
Enumeration date
09/27/2016
Last updated
05/07/2024
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