PRUDENTIAL URGENT CARE & DIAGNOSTIC INC. NPI 1194101618

NPI Information

NPI: 1194101618
Provider Name: PRUDENTIAL URGENT CARE & DIAGNOSTIC, INC.
Classification: Clinic/Center - 261QU0200X
Entity Type: Organization

Specialization: Urgent Care

Address:
4101 NW 3RD CT
SUITE 3
PLANTATION, FL
ZIP 33317
Phone: (954) 530-9280
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PRUDENTIAL URGENT CARE & DIAGNOSTIC, INC. is an urgent care clinic center in Plantation, FL. PRUDENTIAL URGENT CARE & DIAGNOSTIC, INC. NPI is 1194101618. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4101 NW 3RD CT
SUITE 3
PLANTATION, FL
ZIP 33317-857
Phone: (954) 530-9280
Fax: (954) 533-1024

The provider's authorized official is Ollie Royster .
The authorized official title is Manager and has the following contact phone number (954) 530-9280.

The enumeration date for this NPI number is 8/6/2015 and was last updated on 2/27/2017.

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
1	207P00000X	Emergency Medicine		OS1505	FLORIDA	No
2	208D00000X	General Practice		ME79405	FLORIDA	No
3	261QU0200X	Clinic/Center	Urgent Care	OS1505	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	L32023	MEDICARE UPIN	FLORIDA

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: 11/14/2023

NPI Synchronization or Removal

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