Provider Demographics
NPI:1447664495
Name:MEDCARE XPRESS WALK IN CLINIC OF SEMORAN
Entity type:Organization
Organization Name:MEDCARE XPRESS WALK IN CLINIC OF SEMORAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:HILL
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:407-378-5300
Mailing Address - Street 1:3303 S SEMORAN BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-2501
Mailing Address - Country:US
Mailing Address - Phone:407-378-5300
Mailing Address - Fax:407-745-5589
Practice Address - Street 1:3303 S SEMORAN BLVD STE 200
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-2501
Practice Address - Country:US
Practice Address - Phone:407-378-5300
Practice Address - Fax:407-745-5589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-18
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care