Provider Demographics
NPI:1982844163
Name:AMELIA URGENT CARE LLC
Entity Type:Organization
Organization Name:AMELIA URGENT CARE LLC
Other - Org Name:MED XPRESS AT RIVER CITY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MATRICIA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:904-696-0055
Mailing Address - Street 1:96279 BRADY POINT RD
Mailing Address - Street 2:
Mailing Address - City:FERNANDINA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32034-7076
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:510 AIRPORT CENTER DR
Practice Address - Street 2:SUITE 109
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-7257
Practice Address - Country:US
Practice Address - Phone:904-696-0055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-27
Last Update Date:2015-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care