Provider Demographics
NPI:1427670322
Name:IMMEDIATE CARE CLINIC
Entity type:Organization
Organization Name:IMMEDIATE CARE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:PLAZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-900-3257
Mailing Address - Street 1:6979 STIRLING RD
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-7005
Mailing Address - Country:US
Mailing Address - Phone:954-900-3257
Mailing Address - Fax:954-900-3296
Practice Address - Street 1:6979 STIRLING RD
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33314-7005
Practice Address - Country:US
Practice Address - Phone:954-900-3257
Practice Address - Fax:954-900-3296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-13
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty