Physicians Immediate Care Jensen Beach, LLC

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

License

HCC10747 Issued in FL

Legal business name

PHYSICIANS IMMEDIATE CARE JENSEN BEACH, LLC

Practice address

1801 NE Jensen Beach Blvd
Jensen Beach, FL 34957-7233

Phone

(772) 334-1700

Fax

(772) 334-1701

NPI assigned

Apr 3, 2015

Last updated

Apr 7, 2015By the provider in NPPES

Organization subpart

Yes

Parent organization

PHYSICIANS IMMEDIATE CARE, INCAs reported in NPPES

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

Authorized official

Name

Kenneth Palestrant, M.D.

Title

Ceo

Phone

(772) 343-1776

Specialties & licenses 1

Addresses

Part of

Physicians Immediate Care East LLC

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

{
    "created_epoch": "1428019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428364800000",
    "number": "1952796112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 NE JENSEN BEACH BLVD",
            "city": "JENSEN BEACH",
            "state": "FL",
            "postal_code": "349577233",
            "telephone_number": "772-334-1700",
            "fax_number": "772-334-1701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 NE JENSEN BEACH BLVD",
            "city": "JENSEN BEACH",
            "state": "FL",
            "postal_code": "349577233",
            "telephone_number": "772-334-1700",
            "fax_number": "772-334-1701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS IMMEDIATE CARE JENSEN BEACH, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHYSICIANS IMMEDIATE CARE, INC",
        "enumeration_date": "2015-04-03",
        "last_updated": "2015-04-07",
        "status": "A",
        "authorized_official_last_name": "PALESTRANT",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "772-343-1776",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "FL",
            "license": "HCC10747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Urgent Care Clinic/Center in Jensen Beach, FL
• Providers in Jensen Beach, 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 Apr 7, 2015; 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.