Provider Demographics
NPI:1568030070
Name:VITAL URGENT CARE LLC
Entity Type:Organization
Organization Name:VITAL URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NERLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:JESTINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-460-2464
Mailing Address - Street 1:1749 N. MILITARY TRAIL
Mailing Address - Street 2:STE A
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1749 N. MILITARY TRAIL
Practice Address - Street 2:STE A
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-4769
Practice Address - Country:US
Practice Address - Phone:561-223-9846
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-12
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care