Convenient Walk in Medical Clinic Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME31419 Issued in FL

Legal business name

CONVENIENT WALK IN MEDICAL CLINIC INC

Practice address

1611 E Shell Point Rd
Ruskin, FL 33570-5087

Phone

(813) 659-2502

Fax

(813) 659-2584

NPI assigned

Jun 21, 2007

Last updated

Sep 26, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brian Clukie

Title

Administrator

Phone

(813) 659-2502

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190764800000",
    "number": "1871798587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 E SHELL POINT RD",
            "city": "RUSKIN",
            "state": "FL",
            "postal_code": "335705087",
            "telephone_number": "813-659-2502",
            "fax_number": "813-659-2584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 E SHELL POINT RD",
            "city": "RUSKIN",
            "state": "FL",
            "postal_code": "335705087",
            "telephone_number": "813-659-2502",
            "fax_number": "813-659-2584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONVENIENT WALK IN MEDICAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-21",
        "last_updated": "2007-09-26",
        "status": "A",
        "authorized_official_last_name": "CLUKIE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "813-659-2502"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME31419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Ruskin, FL
• Providers in Ruskin, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2007; 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.