Provider Demographics
NPI:1508989757
Name:URGENT CARE PHYSICIANS OF WEST KENDALL LLC
Entity Type:Organization
Organization Name:URGENT CARE PHYSICIANS OF WEST KENDALL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:RAYMOND
Authorized Official - Last Name:NATEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-888-8820
Mailing Address - Street 1:PO BOX 162847
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32716-2847
Mailing Address - Country:US
Mailing Address - Phone:786-888-8820
Mailing Address - Fax:786-591-6025
Practice Address - Street 1:13001 SW 88TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1708
Practice Address - Country:US
Practice Address - Phone:786-596-3800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:URGENT CARE PHYSICIANS OF SOUTH FLORIDA LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-10
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL278548000Medicaid
39169OtherBCBS FL
FL278548000Medicaid