MINIER WATERFORD LAKES LLC NPI 1417155730

NPI Information

NPI: 1417155730
Provider Name: MINIER WATERFORD LAKES LLC
Classification: Clinic/Center - 261QU0200X
Entity Type: Organization

Specialization: Urgent Care

CLIA Number: 10D1079476

Address:
12301 LAKE UNDERHILL RD STE 118
ORLANDO, FL
ZIP 32828
Phone: (407) 249-8870
Get Directions

MINIER WATERFORD LAKES LLC is an urgent care clinic center in Orlando, FL. MINIER WATERFORD LAKES LLC NPI is 1417155730. The provider is registered as an organization entity type.

The provider's business location address is:

12301 LAKE UNDERHILL RD STE 118
ORLANDO, FL
ZIP 32828-510
Phone: (407) 249-8870
Fax: (407) 249-8871

The provider's authorized official is Sanford K Boaz .
The authorized official title is Ceo and has the following contact phone number (407) 257-5782.

The CLIA number assigned to this NPI record is 10D1079476 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/8/2007 and was last updated on 6/5/2008.

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	261QU0200X	Clinic/Center	Urgent Care			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	AJ379	MEDICARE PIN	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: 4/28/2024

NPI Synchronization or Removal

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