Provider Demographics
NPI:1194950907
Name:30 MINUTE MEDICAL LLC
Entity type:Organization
Organization Name:30 MINUTE MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:BIAGIO
Authorized Official - Middle Name:V
Authorized Official - Last Name:VULTAGGIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-777-1650
Mailing Address - Street 1:8540 ARGYLE FOREST BLVD
Mailing Address - Street 2:5
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32244-6702
Mailing Address - Country:US
Mailing Address - Phone:904-777-1650
Mailing Address - Fax:904-777-1665
Practice Address - Street 1:8540 ARGYLE FOREST BLVD
Practice Address - Street 2:5
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32244-6702
Practice Address - Country:US
Practice Address - Phone:904-891-4894
Practice Address - Fax:904-641-5910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-22
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care