Healthcare Provider Details

I. General information

NPI: 1780456152
Provider Name (Legal Business Name): BABA URGENT CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2023
Last Update Date: 11/09/2023
Certification Date: 11/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 MALABAR RD SE STE B
PALM BAY FL
32907-3200
US

IV. Provider business mailing address

948 S WICKHAM RD STE 101
MELBOURNE FL
32904-1647
US

V. Phone/Fax

Practice location:
  • Phone: 321-956-7370
  • Fax:
Mailing address:
  • Phone: 321-956-7370
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GEETHA PRIYANKA
Title or Position: OWNER
Credential: MD
Phone: 321-279-5579