Healthcare Provider Details

I. General information

NPI: 1568867273
Provider Name (Legal Business Name): 911 URGENT CONVENIENT CARE CLINICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2014
Last Update Date: 10/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4820 PARK BLVD N
PINELLAS PARK FL
33781-3534
US

IV. Provider business mailing address

4820 PARK BLVD N
PINELLAS PARK FL
33781-3534
US

V. Phone/Fax

Practice location:
  • Phone: 727-209-6572
  • Fax: 727-209-6685
Mailing address:
  • Phone: 727-209-6572
  • Fax: 727-209-6685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. DALE G BRAMLET
Title or Position: CEO
Credential: MD
Phone: 727-209-6572