Prudential Urgent Care & Diagnostic, Inc.

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

License

OS1505 Issued in FL

Legal business name

PRUDENTIAL URGENT CARE & DIAGNOSTIC, INC.

Practice address

4101 NW 3Rd CT
Suite 3
Plantation, FL 33317-2857

Phone

(954) 530-9280

Fax

(954) 533-1024

NPI assigned

Aug 6, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ollie Royster

Title

Manager

Phone

(954) 530-9280

Specialties & licenses 3

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1438819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488153600000",
    "number": "1194101618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 NW 3RD CT",
            "address_2": "SUITE 3",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333172857",
            "telephone_number": "954-530-9280",
            "fax_number": "954-533-1024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 NW 3RD CT",
            "address_2": "SUITE 3",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333172857",
            "telephone_number": "954-530-9280",
            "fax_number": "954-533-1024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRUDENTIAL URGENT CARE & DIAGNOSTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-06",
        "last_updated": "2017-02-27",
        "status": "A",
        "authorized_official_last_name": "ROYSTER",
        "authorized_official_first_name": "OLLIE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "954-530-9280"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS1505",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME79405",
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "FL",
            "license": "OS1505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Urgent Care Clinic/Center in Plantation, FL
• Providers in Plantation, FL by specialty
• Urgent Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.