Provider Demographics
NPI:1487084414
Name:MAXIMUM CARE WALK-IN CLINIC
Entity type:Organization
Organization Name:MAXIMUM CARE WALK-IN CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ARNP, FNP BC
Authorized Official - Prefix:MRS
Authorized Official - First Name:BERNADINE
Authorized Official - Middle Name:CARLINE
Authorized Official - Last Name:HENRY-CLARKE
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:561-557-1819
Mailing Address - Street 1:6079 LAKE WORTH ROAD
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463
Mailing Address - Country:US
Mailing Address - Phone:556-557-1819
Mailing Address - Fax:561-557-1982
Practice Address - Street 1:6079 LAKE WORTH ROAD
Practice Address - Street 2:6079
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463
Practice Address - Country:US
Practice Address - Phone:556-557-1819
Practice Address - Fax:561-557-1982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-12
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1356418875Medicare NSC