Dr. Patrick J. Fullerton, Inc

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

License

OS8087 Issued in FL

Legal business name

DR. PATRICK J. FULLERTON, INC

Practice address

2441 S Hiawassee Rd
Orlando, FL 32835-6347

Phone

(407) 378-6339

Fax

(401) 378-6466

NPI assigned

Mar 7, 2013

Organization subpart

No

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

Authorized official

Name

Patrick J Fullerton, D.O.

Title

Owner

Phone

(407) 754-5077

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• StatMedX Urgent Care Doing business as

Locations

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

{
    "created_epoch": "1362614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374451200000",
    "number": "1962743450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2441 S HIAWASSEE RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328356347",
            "telephone_number": "407-378-6339",
            "fax_number": "407-378-6466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2441 S HIAWASSEE RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328356347",
            "telephone_number": "407-378-6339",
            "fax_number": "401-378-6466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. PATRICK J. FULLERTON, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-07",
        "last_updated": "2013-07-22",
        "status": "A",
        "authorized_official_last_name": "FULLERTON",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-754-5077",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "FL",
            "license": "OS8087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271297100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "StatMedX Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Urgent Care Clinic/Center in Orlando, FL
• Providers in Orlando, 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 Jul 22, 2013; 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.