Healthcare Provider Details
I. General information
NPI: 1093722761
Provider Name (Legal Business Name): URGENT CARE USA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/02/2006
Last Update Date: 03/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
413 N ALEXANDER ST
PLANT CITY FL
33563-4305
US
IV. Provider business mailing address
P.O. BOX 570
LITHIA FL
33547-0570
US
V. Phone/Fax
- Phone: 813-752-7222
- Fax: 813-681-2611
- Phone: 813-752-7222
- Fax: 813-681-2611
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | ME 62902 |
| License Number State | FL |
VIII. Authorized Official
Name: MR.
MICHAEL
SALVATO
Title or Position: MEDICAL DIRECTOR
Credential:
Phone: 813-752-7222