Healthcare Provider Details

I. General information

NPI: 1629189410
Provider Name (Legal Business Name): UNIVERSITY WALK-IN MEDICAL CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 12/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11550 UNIVERSITY BLVD
ORLANDO FL
32817-2100
US

IV. Provider business mailing address

11550 UNIVERSITY BLVD
ORLANDO FL
32817-2100
US

V. Phone/Fax

Practice location:
  • Phone: 407-282-2044
  • Fax: 407-658-1596
Mailing address:
  • Phone: 407-282-2044
  • Fax: 407-658-1596

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberOS8339
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: VICTOR YOUNG
Title or Position: VICE PRESIDENT
Credential: D.O.
Phone: 407-282-2044