Healthcare Provider Details

I. General information

NPI: 1639301443
Provider Name (Legal Business Name): URGENT CARE OF BROWARD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2009
Last Update Date: 08/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4121 NW 5TH ST 215
PLANTATION FL
33317-2120
US

IV. Provider business mailing address

PO BOX 16404
PLANTATION FL
33318-6404
US

V. Phone/Fax

Practice location:
  • Phone: 954-583-0504
  • Fax: 954-583-0610
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberME 43064
License Number StateFL

VIII. Authorized Official

Name: JESSEH RAMAIN
Title or Position: OFFICE MANAGER
Credential:
Phone: 954-583-0504