Healthcare Provider Details

I. General information

NPI: 1598282113
Provider Name (Legal Business Name): SALUD URGENT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2017
Last Update Date: 08/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3107 13TH STREET
SAINT CLOUD FL
34769
US

IV. Provider business mailing address

3744 MARIETTA WAY
SAINT CLOUD FL
34772
US

V. Phone/Fax

Practice location:
  • Phone: 407-957-7700
  • Fax:
Mailing address:
  • Phone: 407-957-7700
  • Fax:

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 Number
License Number State

VIII. Authorized Official

Name: SHEEJA JACOB
Title or Position: DIRECTOR
Credential:
Phone: 407-520-9377