Healthcare Provider Details

I. General information

NPI: 1528742558
Provider Name (Legal Business Name): GI URGENT CARE OF FLORIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2023
Last Update Date: 11/14/2024
Certification Date: 11/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 N DEAN RD STE 110
ORLANDO FL
32825-3731
US

IV. Provider business mailing address

206 N DEAN RD STE 110
ORLANDO FL
32825-3731
US

V. Phone/Fax

Practice location:
  • Phone: 407-384-7388
  • Fax:
Mailing address:
  • Phone: 407-900-7184
  • Fax: 407-420-0103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. SRINIVAS SEELA
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 407-900-7184