Healthcare Provider Details

I. General information

NPI: 1689578148
Provider Name (Legal Business Name): PEDSCOVE URGENT CARE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 SE 25TH LOOP
OCALA FL
34471-6090
US

IV. Provider business mailing address

3135 TALA LOOP
LONGWOOD FL
32779-3129
US

V. Phone/Fax

Practice location:
  • Phone: 407-509-1643
  • Fax:
Mailing address:
  • Phone: 407-509-1643
  • Fax:

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: OLUDAPO F SOREMI
Title or Position: PROVIDER
Credential: MD
Phone: 407-468-1204