Prima Vista Walk-in Medical Center, Inc.

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

Legal business name

PRIMA VISTA WALK-IN MEDICAL CENTER, INC.

Practice address

784 E Prima Vista Blvd
Port St Lucie, FL 34952-2271

Phone

(772) 878-7311

Fax

(772) 878-7321

NPI assigned

Apr 6, 2007

Organization subpart

No

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

Authorized official

Name

Miss Sylvia A. Mendoza

Title

President

Phone

(772) 878-7311

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196640000000",
    "number": "1952423113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "784 E PRIMA VISTA BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349522271",
            "telephone_number": "772-878-7311",
            "fax_number": "772-878-7321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "784 E PRIMA VISTA BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349522271",
            "telephone_number": "772-878-7311",
            "fax_number": "772-878-7321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMA VISTA WALK-IN MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2007-12-03",
        "status": "A",
        "authorized_official_last_name": "MENDOZA",
        "authorized_official_first_name": "SYLVIA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "772-878-7311",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GRP # FACILITY",
            "identifier": "72956",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Adult Medicine Physician in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Adult Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.