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General NPI Number Information
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NPI Number | 1275358855
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Entity Type | Organization
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Legal Business Name | ST TIMOTHY URGENT CARE
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Dates
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Enumeration Date | 11/19/2024
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Last Update Date | 10/16/2025
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Provider Practice Location Address
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Address Line | 16244 REDSTONE WAY
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City | ODESSA
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State | FL
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Zip | 33556-4668
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Country | US
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Telephone | 352-835-7111
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Fax | 727-223-4159
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Provider Business Mailing Address
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Address Line | 16244 REDSTONE WAY
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City | ODESSA
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State | FL
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Zip | 33556-4668
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Country | US
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Telephone | 813-430-0900
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Fax | 813-430-0800
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Authorized Official
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Title or Position | OWNER
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Name | EID GUIRGUIS
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Credential | MD
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Telephone | 352-835-7111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2080P0204X
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Taxonomy Name | Pediatric Emergency Medicine (Pediatrics) Physician
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License Number |
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License Number State |
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