Provider Demographics
NPI:1629235973
Name:PARSONS WALK-IN CLINIC
Entity Type:Organization
Organization Name:PARSONS WALK-IN CLINIC
Other - Org Name:LIBERTY WALK-IN CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:AMARJIT
Authorized Official - Middle Name:S
Authorized Official - Last Name:DHALIWAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-689-8900
Mailing Address - Street 1:PO BOX 3550
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33509-3550
Mailing Address - Country:US
Mailing Address - Phone:813-689-8900
Mailing Address - Fax:813-653-9696
Practice Address - Street 1:8342 US HIGHWAY 301 N
Practice Address - Street 2:
Practice Address - City:PARRISH
Practice Address - State:FL
Practice Address - Zip Code:34219-8653
Practice Address - Country:US
Practice Address - Phone:941-729-4400
Practice Address - Fax:941-729-4424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK8643Medicare PIN