NPIMap

Organization Active NPI

Dairy Road Urgent Care LLC

  • Urgent Care Clinic/Center
  • Melbourne, FL
National Provider Identifier
1265765531
Registry record updated Apr 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
License
ME82880 Issued in FL
Legal business name
DAIRY ROAD URGENT CARE LLC
Practice address
2107 Dairy Rd
Melbourne, FL 32904-5209
Phone
(321) 956-8224
Fax
(321) 956-8225
NPI assigned
Sep 17, 2009
Last updated
Apr 23, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2016

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

Authorized official

Name
Dr. Miguel Lynn Lorente, MDNPI 1164448072
Title
President
Phone
(321) 956-8224

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X ME82880 FL Primary

Addresses

Primary practice location

2107 Dairy Rd
Melbourne, FL 32904-5209

Mailing address

PO Box 120043
West Melbourne, FL 32912-0043
Phone (321) 956-8224

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091221000616 FL Part B Supplier - Clinic/Group Practice 9133269293 Receives reassigned benefits from 12 practitioners
Practice locations: Melbourne, FL

National Provider Directory

National Provider Directory

Locations

2107 Dairy Rd
Unit B
Melbourne, FL 32904

2107 Dairy Rd
West Melbourne, FL 32904
Phone (321) 676-7860

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1253145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461369600000",
    "number": "1265765531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 120043",
            "city": "WEST MELBOURNE",
            "state": "FL",
            "postal_code": "329120043",
            "telephone_number": "321-956-8224",
            "fax_number": "321-956-8225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2107 DAIRY RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329045209",
            "telephone_number": "321-956-8224",
            "fax_number": "321-956-8225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAIRY ROAD URGENT CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-17",
        "last_updated": "2016-04-23",
        "status": "A",
        "authorized_official_last_name": "LORENTE",
        "authorized_official_first_name": "MIGUEL",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-956-8224",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "FL",
            "license": "ME82880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.