| Crestview Immediate Care LLC | |
|
4100 S Ferdon Blvd Ste A3 Crestview FL 32536-5287 | |
| (850) 758-7791 | |
| Not Available |
| Full Name | Crestview Immediate Care LLC |
|---|---|
| Speciality | Nurse Practitioner - Family |
| Location | 4100 S Ferdon Blvd Ste A3, Crestview, Florida |
| Authorized Official Name and Position | Aliason Heather Martin-overton (OWNER) |
| Authorized Official Contact | 8506346345 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crestview Immediate Care LLC 4100 S Ferdon Blvd Ste A3 Crestview FL 32536-5287 Ph: (850) 634-6345 | Crestview Immediate Care LLC 4100 S Ferdon Blvd Ste A3 Crestview FL 32536-5287 Ph: (850) 758-7791 |
| NPI Number | 1073134730 |
|---|---|
| Provider Enumeration Date | 05/04/2020 |
| Last Update Date | 06/09/2020 |
| Certification Date | 06/09/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073134730 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Secondary |
| 363LF0000X | Nurse Practitioner - Family | () | Primary |
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