Healthcare Provider Details

I. General information

NPI: 1306119508
Provider Name (Legal Business Name): EMERGI-CARE,INC,EMERGI-CARE MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2012
Last Update Date: 04/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 S APOPKA VINELAND RD
ORLANDO FL
32819-3127
US

IV. Provider business mailing address

4800 S APOPKA VINELAND RD
ORLANDO FL
32819-3127
US

V. Phone/Fax

Practice location:
  • Phone: 407-876-5555
  • Fax: 407-876-5557
Mailing address:
  • Phone: 407-876-5555
  • Fax: 407-876-5557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberME34630
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number34630
License Number StateFL

VIII. Authorized Official

Name: DR. USHA JAIN
Title or Position: DIRECTOR
Credential: MD
Phone: 407-876-5555