Provider Demographics
NPI:1427265776
Name:ER QUICKCARE PL
Entity type:Organization
Organization Name:ER QUICKCARE PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:ROSENFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-403-3772
Mailing Address - Street 1:13030 LIVINGSTON RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34105-5024
Mailing Address - Country:US
Mailing Address - Phone:239-403-3772
Mailing Address - Fax:
Practice Address - Street 1:13030 LIVINGSTON RD
Practice Address - Street 2:SUITE 3
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34105-5024
Practice Address - Country:US
Practice Address - Phone:239-403-3772
Practice Address - Fax:239-403-3770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0053433261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLB911UOtherBLUE CROSS BLUE SHIELD
FL40884OtherBCBS GROUP
FL372225200Medicaid
FL010065837OtherRAILROAD MEDICARE
FL1093813669OtherROSENFIELD NPI
FLB911UOtherBLUE CROSS BLUE SHIELD
FL6134790001Medicare NSC