Provider Demographics
NPI:1700412004
Name:EMED URGENT CARE LLC
Entity Type:Organization
Organization Name:EMED URGENT CARE LLC
Other - Org Name:EMED MULTISPECIALTY GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:AURORA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-513-3240
Mailing Address - Street 1:2624 ATLANTIC BLVD STE 4
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-3633
Mailing Address - Country:US
Mailing Address - Phone:904-513-3240
Mailing Address - Fax:904-379-2911
Practice Address - Street 1:2624 ATLANTIC BLVD STE 4
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-3633
Practice Address - Country:US
Practice Address - Phone:904-513-3240
Practice Address - Fax:904-379-2911
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EMED URGENT AND PRIMARY CARE PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-03-18
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL27-1929223OtherTIN