Organization
PHYSICIANS IMMEDIATE CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH J PALESTRANT (PHYSICIAN)
(772) 343-1774
Entity
Organization
Contact information
Practice address
4007 SW PORT ST LUCIE BLVD, SUITE #12, PORT ST LUCIE, FL 34953-5679
(772) 343-1774
(772) 343-1744
Mailing address
3607 OLD CONEJO RD, THOUSAND OAKS, CA 91320-2123
(805) 375-0800
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
FP0126222
FL
Other
Enumeration date
03/12/2008
Last updated
03/12/2008
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