Provider Demographics
NPI:1508840208
Name:TEQUESTA URGENT CARE, LLC.
Entity Type:Organization
Organization Name:TEQUESTA URGENT CARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCINE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRECO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:561-747-4464
Mailing Address - Street 1:1 MAIN ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:TEQUESTA
Mailing Address - State:FL
Mailing Address - Zip Code:33469-4709
Mailing Address - Country:US
Mailing Address - Phone:561-747-4464
Mailing Address - Fax:561-747-5598
Practice Address - Street 1:1 MAIN ST
Practice Address - Street 2:SUITE 102
Practice Address - City:TEQUESTA
Practice Address - State:FL
Practice Address - Zip Code:33469-4709
Practice Address - Country:US
Practice Address - Phone:561-747-4464
Practice Address - Fax:561-747-5598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC5420261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLB903FOtherBLUE CROSS BLUE SHIELD
FLK4621Medicare ID - Type Unspecified