MEDFAST URGENT CARE CENTER LLC NPI 1164064200

NPI Information

  • NPI: 1164064200
  • Provider Name: MEDFAST URGENT CARE CENTER, LLC
  • Classification: Clinic/Center - 261QU0200X
  • Specialization: Urgent Care
  • Entity Type: Organization
  • CLIA Number: 10D2174608
  • Address: 1000 S RIDGEWOOD AVE
    EDGEWATER, FL
    ZIP 32132
  • Phone: (386) 220-8222

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NPI Details

MEDFAST URGENT CARE CENTER, LLC is an urgent care clinic center in Edgewater, FL. MEDFAST URGENT CARE CENTER, LLC NPI is 1164064200. The provider is registered as an organization entity type.

The provider's business location address is:

1000 S RIDGEWOOD AVE
EDGEWATER, FL
ZIP 32132-333
Phone: (386) 220-8222
Fax: (386) 220-8233

The provider's authorized official is Marilyn Stevens .
The authorized official title is Billing Director and has the following contact phone number (321) 821-4950.

The CLIA number assigned to this NPI record is 10D2174608 - other - urgent care center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/10/2019 and was last updated on 6/17/2020.

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 CareYes

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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