Provider Demographics
NPI:1285193243
Name:OASIS URGENT CARE, PLLC
Entity Type:Organization
Organization Name:OASIS URGENT CARE, PLLC
Other - Org Name:OASIS URGENT CARE, PLLC
Other - Org Type:Other Name
Authorized Official - Title/Position:PHYSICIAN ASSISTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:M
Authorized Official - Last Name:ALMANZAR
Authorized Official - Suffix:I
Authorized Official - Credentials:PA
Authorized Official - Phone:239-285-6649
Mailing Address - Street 1:3164 PALM BEACH BLVD STE 104-D
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33916-1579
Mailing Address - Country:US
Mailing Address - Phone:239-285-6649
Mailing Address - Fax:239-264-4982
Practice Address - Street 1:3164 PALM BEACH BLVD
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33916-1579
Practice Address - Country:US
Practice Address - Phone:239-590-8399
Practice Address - Fax:239-264-4982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-18
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1285193243Medicaid