Provider Demographics
NPI:1255852471
Name:ST VINCENT'S URGENT CARE INC
Entity Type:Organization
Organization Name:ST VINCENT'S URGENT CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ESTRELLITA
Authorized Official - Middle Name:
Authorized Official - Last Name:REDMON
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MBA
Authorized Official - Phone:904-296-4368
Mailing Address - Street 1:4205 BELFORT RD STE 4015
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-3623
Mailing Address - Country:US
Mailing Address - Phone:904-450-6014
Mailing Address - Fax:904-450-6015
Practice Address - Street 1:2001 COUNTRY ROAD 210 WEST
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32092
Practice Address - Country:US
Practice Address - Phone:904-450-6014
Practice Address - Fax:904-450-6015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-28
Last Update Date:2017-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care