| Walk In Medical Clinic And Fitness Center, Llc | |
|
3105 Innovation Dr Ste A Saint Cloud FL 34769-6501 | |
| (407) 498-0539 | |
| (877) 203-2038 |
| Full Name | Walk In Medical Clinic And Fitness Center, Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 3105 Innovation Dr Ste A, Saint Cloud, Florida |
| Authorized Official Name and Position | Nicanor C. Lopez (OWNER) |
| Authorized Official Contact | 2674758447 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Walk In Medical Clinic And Fitness Center, Llc 3105 Innovation Dr Ste A Saint Cloud FL 34769-6501 Ph: (407) 498-0539 | Walk In Medical Clinic And Fitness Center, Llc 3105 Innovation Dr Ste A Saint Cloud FL 34769-6501 Ph: (407) 498-0539 |
| NPI Number | 1518268283 |
|---|---|
| Provider Enumeration Date | 11/10/2010 |
| Last Update Date | 11/11/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518268283 | NPI | - | NPPES |
| 0368398000 | Other | NJ | AMERIHEALTH |
| 550663UKE | Other | NJ | MEDICARE ID-TYPE UNSPECIFIED |
| 60018874 | Other | NJ | HORIZON NJ HEALTH |
| 001759700 | Medicaid | FL | |
| 5114306 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 105419 (Florida) | Primary |
| 261QP2300X | Clinic/center - Primary Care | MD037726L (Pennsylvania) | Secondary |
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