Provider Demographics
NPI:1720314438
Name:HEALTH FIRST QUICKCARE LLC
Entity Type:Organization
Organization Name:HEALTH FIRST QUICKCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VP/CFO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:FELKNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-434-5687
Mailing Address - Street 1:PO BOX 560858
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32958-0858
Mailing Address - Country:US
Mailing Address - Phone:321-434-4600
Mailing Address - Fax:321-434-4662
Practice Address - Street 1:1350 S HICKORY ST
Practice Address - Street 2:SUITE 103
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-3224
Practice Address - Country:US
Practice Address - Phone:321-434-1735
Practice Address - Fax:321-434-1796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-30
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CP883AMedicare PIN