Provider Demographics
NPI:1851344378
Name:SOLANTIC/SOUTH FLORIDA, LLC
Entity Type:Organization
Organization Name:SOLANTIC/SOUTH FLORIDA, LLC
Other - Org Name:CARESPOT EXPRESS HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:WEBSTER
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLINKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-550-0821
Mailing Address - Street 1:10151 DEERWOOD PARK BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-0566
Mailing Address - Country:US
Mailing Address - Phone:904-854-1545
Mailing Address - Fax:
Practice Address - Street 1:1205 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-6620
Practice Address - Country:US
Practice Address - Phone:954-780-8134
Practice Address - Fax:954-227-2710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK8924Medicare PIN