Provider Demographics
NPI:1679742787
Name:MEDICAL TECHNOLOGY TRANSFER CORPORATION
Entity Type:Organization
Organization Name:MEDICAL TECHNOLOGY TRANSFER CORPORATION
Other - Org Name:4CARE WALK IN CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCAHILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-726-3850
Mailing Address - Street 1:590 MALABAR RD SE
Mailing Address - Street 2:SUITE 7
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32907-3108
Mailing Address - Country:US
Mailing Address - Phone:321-676-3535
Mailing Address - Fax:321-676-3575
Practice Address - Street 1:590 MALABAR RD SE
Practice Address - Street 2:SUITE 7
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32907-3108
Practice Address - Country:US
Practice Address - Phone:321-676-3535
Practice Address - Fax:321-676-3575
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDICAL TECHNOLOGY TRANSFER CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-22
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care