Provider Demographics
NPI:1962685230
Name:ACCIDENT & MEDICAL WALK-IN CLINIC, INC
Entity type:Organization
Organization Name:ACCIDENT & MEDICAL WALK-IN CLINIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:W
Authorized Official - Last Name:GALBRAITH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:352-797-5500
Mailing Address - Street 1:20205 CORTEZ BLVD
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34601-3847
Mailing Address - Country:US
Mailing Address - Phone:352-797-5500
Mailing Address - Fax:352-797-5524
Practice Address - Street 1:20205 CORTEZ BLVD
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34601-3847
Practice Address - Country:US
Practice Address - Phone:352-797-5500
Practice Address - Fax:352-797-5524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-10
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS7350208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK2184Medicare PIN