1St Choice Urgent Care Center LLC
Organization Active NPI Urgent Care Clinic/Center · Lake Butler, FL
NPI 1376296194 · NPPES record last updated Feb 1, 2022
Key facts
- NPI
- 1376296194
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Urgent Care Clinic/Center 261QU0200X
- Legal business name
- 1ST CHOICE URGENT CARE CENTER LLC
- Practice address
- 275 W Main St
Lake Butler, FL 32054-1656 - Phone
- (386) 496-2273
- NPI assigned
- Feb 1, 2022
- Organization subpart
- Yes
- Parent organization (as reported)
- 1ST CHOICE URGENT CARE CENTER LLC
Authorized official
- Name
- John Distefano
- Title
- Consultant
- Phone
- (352) 317-3214
Parent organization (reported in NPPES) 1
Other NPIs on the same Medicare enrollment 2
Corporate family (same tax ID) 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130529000307 | FL | Part B Supplier - Clinic/Group Practice | 8224276571 |
Receives reassigned benefits from 1 practitioner 2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Lake Butler, FL; Newberry, FL |
National Provider Directory
- Tax ID family
- 1St Choice Urgent Care Center LLC
- Part of
- 1St Choice Urgent Care Center LLC
Locations
817 NW 56th Ter
Ste A
Gainesville, FL 32605
128 NW 137th Dr
Newberry, FL 32669
Phone (352) 258-4452
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | |||
| Urgent Care Clinic/Center | 261QU0200X | Yes |
Addresses
Primary practice location
275 W Main St
Lake Butler, FL 32054-1656
Mailing address
817 NW 56TH Ter Ste a
Gainesville, FL 32605-6401
Phone (352) 336-0964
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12609 | Other | FL | CLINIC LICENSE |
Other providers in Lake Butler, FL
- 1St Choice Urgent Care Center LLC
- A Touch of Heaven Massage Therapy Center, LLC
- Patricia Adelufosi
- Nalini Anandjiwala
- Cheryl Anderson Caska
All providers in Lake Butler, FL · Urgent Care Clinic/Center in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 1, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.