CRESCENT BEACH CARE LLC NPI 1033451380

NPI Information

  • NPI: 1033451380
  • Provider Name: CRESCENT BEACH CARE, LLC
  • Classification: Clinic/Center - 261QU0200X
  • Specialization: Urgent Care
  • Entity Type: Organization
  • CLIA Number: 10D2063011
  • Address: 6573 A1A S
    SAINT AUGUSTINE, FL
    ZIP 32080
  • Phone: (904) 342-7363

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NPI Details

CRESCENT BEACH CARE, LLC is an urgent care clinic center in Saint Augustine, FL. CRESCENT BEACH CARE, LLC NPI is 1033451380. The provider is registered as an organization entity type.

The provider's business location address is:

6573 A1A S
SAINT AUGUSTINE, FL
ZIP 32080-504
Phone: (904) 342-7363
Fax: (904) 342-7367

The provider's authorized official is Adrian Shane Long .
The authorized official title is Member-managed and has the following contact phone number (904) 342-7363.

The CLIA number assigned to this NPI record is 10D2063011 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/25/2013 and was last updated on 5/18/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QU0200XClinic/CenterUrgent CareME109167FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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