Provider Demographics
NPI:1407320476
Name:1ST CALL URGENT CARE
Entity Type:Organization
Organization Name:1ST CALL URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:KAYOMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:662-820-1099
Mailing Address - Street 1:PO BOX 950819
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32795-0819
Mailing Address - Country:US
Mailing Address - Phone:662-820-1099
Mailing Address - Fax:321-926-3321
Practice Address - Street 1:173 NORTH C.R. BEALL BLVD.
Practice Address - Street 2:SUITE 106
Practice Address - City:DEBBARY
Practice Address - State:FL
Practice Address - Zip Code:32713
Practice Address - Country:US
Practice Address - Phone:662-820-1099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-14
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty