Healthcare Provider Details

I. General information

NPI: 1205169281
Provider Name (Legal Business Name): URGENT CARE AND SURGERY CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2009
Last Update Date: 03/11/2020
Certification Date: 03/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 SHERIDAN ST STE A
HOLLYWOOD FL
33021-3558
US

IV. Provider business mailing address

4000 SHERIDAN ST STE A
HOLLYWOOD FL
33021-3558
US

V. Phone/Fax

Practice location:
  • Phone: 954-239-6060
  • Fax: 954-239-6100
Mailing address:
  • Phone: 954-239-6060
  • Fax: 954-239-6100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License NumberMM23282
License Number StateFL

VIII. Authorized Official

Name: CHRISTOPHER METZLER
Title or Position: PRESIDENT
Credential: MD
Phone: 954-239-6060