Healthcare Provider Details
I. General information
NPI: 1316613839
Provider Name (Legal Business Name): CARESPOT OF ORLANDO HSI URGENT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/17/2021
Last Update Date: 08/17/2021
Certification Date: 08/17/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2555 S KIRKMAN RD
ORLANDO FL
32811-2346
US
IV. Provider business mailing address
115 EASTPARK DR STE 300
BRENTWOOD TN
37027-2311
US
V. Phone/Fax
- Phone: 407-362-2030
- Fax:
- Phone: 615-600-4100
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SIERRA
MANNING
Title or Position: CREDENTIALING COORDINATOR
Credential:
Phone: 904-900-5436