Provider Demographics
NPI:1639445596
Name:APPLE URGENT CARES, L.L.C.
Entity Type:Organization
Organization Name:APPLE URGENT CARES, L.L.C.
Other - Org Name:FLAGLER & VOLUSIA REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MGRM
Authorized Official - Prefix:DR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:C
Authorized Official - Last Name:CARLISI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:386-237-4003
Mailing Address - Street 1:1400 E MOODY BLVD
Mailing Address - Street 2:
Mailing Address - City:BUNNELL
Mailing Address - State:FL
Mailing Address - Zip Code:32110-5916
Mailing Address - Country:US
Mailing Address - Phone:386-313-2599
Mailing Address - Fax:386-313-2577
Practice Address - Street 1:1400 EAST MOODY BLVD
Practice Address - Street 2:
Practice Address - City:BUNNELL
Practice Address - State:FL
Practice Address - Zip Code:32110-5916
Practice Address - Country:US
Practice Address - Phone:386-313-2599
Practice Address - Fax:386-313-2577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-26
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CH9168111N00000X
FLOS10016208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty