Provider Demographics
NPI:1083766901
Name:VIP URGENT CARE INC.
Entity Type:Organization
Organization Name:VIP URGENT CARE INC.
Other - Org Name:GARDENS URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:TYLER
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-626-4878
Mailing Address - Street 1:3555 NORTHLAKE BLVD STE 2
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33403-1625
Mailing Address - Country:US
Mailing Address - Phone:561-626-4878
Mailing Address - Fax:
Practice Address - Street 1:3555 NORTHLAKE BLVD STE 2
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33403-1625
Practice Address - Country:US
Practice Address - Phone:561-626-4878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME76345261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG78292Medicare UPIN
FLK9414Medicare PIN