Healthcare Provider Details

I. General information

NPI: 1629652623
Provider Name (Legal Business Name): LATIN URGENT CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2021
Last Update Date: 06/08/2022
Certification Date: 05/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1906 N. JOHN YOUNG PARKWAY
KISSIMMEE FL
34741
US

IV. Provider business mailing address

1906 N. JOHN YOUNG PARKWAY
KISSIMMEE FL
34741
US

V. Phone/Fax

Practice location:
  • Phone: 407-201-4560
  • Fax: 407-201-4461
Mailing address:
  • Phone: 407-201-4560
  • Fax: 407-201-4461

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. LUCIANO GARCIA RANQEL SR.
Title or Position: PRESIDENT
Credential:
Phone: 407-728-3402