Healthcare Provider Details

I. General information

NPI: 1609617620
Provider Name (Legal Business Name): TCH URGENT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2024
Last Update Date: 01/15/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17190 SE 109TH TERRACE RD
SUMMERFIELD FL
34491-9017
US

IV. Provider business mailing address

17190 SE 109TH TERRACE RD
SUMMERFIELD FL
34491-9017
US

V. Phone/Fax

Practice location:
  • Phone: 352-268-0003
  • Fax: 855-642-1129
Mailing address:
  • Phone: 352-268-0003
  • Fax: 855-642-1129

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. SHRIKANTH P UPADYA
Title or Position: OWNER / CEO
Credential: MD
Phone: 352-268-0003