1760876866 NPI number — KIDS FIRST URGENT CARE AFTER HOURS, LLC

Table of content: (NPI 1760876866)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760876866 NPI number — KIDS FIRST URGENT CARE AFTER HOURS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KIDS FIRST URGENT CARE AFTER HOURS, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1760876866
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/26/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13550 SW 88TH ST
Provider Second Line Business Mailing Address:
SUITE 160
Provider Business Mailing Address City Name:
MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33186-1654
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-385-7304
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2627 NE 203RD ST
Provider Second Line Business Practice Location Address:
SUITE 110
Provider Business Practice Location Address City Name:
AVENTURA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33180-1900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-375-4371
Provider Business Practice Location Address Fax Number:
305-380-8477
Provider Enumeration Date:
03/26/2015

Additional Information

Authorized Official

Authorized Official Last Name:
SWARTZ
Authorized Official First Name:
ALAN
Authorized Official Middle Name:
NILS
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
305-385-7304

Provider Taxonomy Codes

  • Taxonomy code: 261QU0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: ME35970 . This is a "MEDICAL LICENSE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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