Provider Demographics
NPI:1639356215
Name:PRI-MED WALK IN CLINIC
Entity Type:Organization
Organization Name:PRI-MED WALK IN CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:MARSDEN
Authorized Official - Last Name:MURRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-572-9199
Mailing Address - Street 1:7200 W COMMERCIAL BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33319-2148
Mailing Address - Country:US
Mailing Address - Phone:954-572-9199
Mailing Address - Fax:
Practice Address - Street 1:7200 W COMMERCIAL BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33319-2148
Practice Address - Country:US
Practice Address - Phone:954-572-9199
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-26
Last Update Date:2008-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME-0066803207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK6097Medicare PIN