Organization
PRIMA VISTA WALK-IN MEDICAL CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS SYLVIA A. MENDOZA (PRESIDENT)
(772) 878-7311
Entity
Organization
Contact information
Practice address
784 E PRIMA VISTA BLVD, PORT ST LUCIE, FL 34952-2271
(772) 878-7311
(772) 878-7321
Mailing address
784 E PRIMA VISTA BLVD, PORT ST LUCIE, FL 34952-2271
(772) 878-7311
(772) 878-7321
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
72956
GRP # FACILITY
FL
Enumeration date
04/06/2007
Last updated
12/03/2007
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