| Edcare Walk In Clinic | |
|
10000 Stirling Rd Ste 7 Hollywood FL 33024-8067 | |
| (810) 265-2802 | |
| Not Available |
| Full Name | Edcare Walk In Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 10000 Stirling Rd Ste 7, Hollywood, Florida |
| Authorized Official Name and Position | Harishchandra G Rathod (DIRECTOR) |
| Authorized Official Contact | 8129727761 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Edcare Walk In Clinic 10000 Stirling Rd Ste 7 Hollywood FL 33024-8067 Ph: (810) 265-2802 | Edcare Walk In Clinic 10000 Stirling Rd Ste 7 Hollywood FL 33024-8067 Ph: (810) 265-2802 |
| NPI Number | 1407153554 |
|---|---|
| Provider Enumeration Date | 02/24/2011 |
| Last Update Date | 10/02/2023 |
| Medicare PECOS PAC ID | 0840452306 |
|---|---|
| Medicare Enrollment ID | O20120427000587 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407153554 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 01064877A (Indiana) | Secondary |
| 261QU0200X | Clinic/center - Urgent Care | 01064877A (Indiana) | Primary |
| Provider Name | Vijayalakshmi Sripathy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508925652 PECOS PAC ID: 5698727394 Enrollment ID: I20050210000442 |
| Provider Name | Harishchandra Rathod |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487680005 PECOS PAC ID: 2860567690 Enrollment ID: I20080813000736 |
| Provider Name | Tanya Ruth Reynolds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407954696 PECOS PAC ID: 6406905223 Enrollment ID: I20090527000078 |
| Provider Name | Vickie Lynn Emberton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730529413 PECOS PAC ID: 4082858741 Enrollment ID: I20130918000782 |
| Provider Name | Kristina M Reynolds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952774762 PECOS PAC ID: 5799080305 Enrollment ID: I20160219000262 |
| Provider Name | Thembelani Dube |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467968040 PECOS PAC ID: 4183976574 Enrollment ID: I20181012001720 |
| Provider Name | Maydia S Facey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851890370 PECOS PAC ID: 1052663440 Enrollment ID: I20181012001881 |
| Provider Name | Satyanarayana Ganapathi Raju |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083623581 PECOS PAC ID: 1850498239 Enrollment ID: I20181017002231 |
| Provider Name | Angela Frantsi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033682588 PECOS PAC ID: 5597001321 Enrollment ID: I20190115002021 |
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