Healthcare Provider Details

I. General information

NPI: 1427468305
Provider Name (Legal Business Name): BROWARD OUTPATIENT URGENT CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2014
Last Update Date: 06/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 S ANDREWS AVE SUITE 201
POMPANO BEACH FL
33069-3298
US

IV. Provider business mailing address

150 S ANDREWS AVE SUITE 201
POMPANO BEACH FL
33069-3298
US

V. Phone/Fax

Practice location:
  • Phone: 954-941-2969
  • Fax: 954-960-6858
Mailing address:
  • Phone: 954-941-2969
  • Fax: 954-960-6858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number13815
License Number StateFL

VIII. Authorized Official

Name: MRS. STACEY B CASTROVINCI
Title or Position: DIRECTOR OF OPERATIONS
Credential: R.N.
Phone: 954-941-2969