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General NPI Number Information
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NPI Number | 1497930093
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Entity Type | Organization
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Legal Business Name | HEALING URGENT CARE
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Dates
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Enumeration Date | 01/02/2008
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Last Update Date | 01/02/2008
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Provider Practice Location Address
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Address Line | 4005 NW 114TH AVE UNIT 3
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City | DORAL
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State | FL
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Zip | 33178-4372
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Country | US
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Telephone | 305-591-2988
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Fax | 305-591-2995
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Provider Business Mailing Address
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Address Line | 4005 NW 114TH AVE UNIT 3
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City | DORAL
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State | FL
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Zip | 33178-4372
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Country | US
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Telephone | 305-591-2988
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Fax | 305-591-2995
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WILSON LOPEZ
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Credential | M.D.
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Telephone | 305-591-2988
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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 | 6176523
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License Number State | FL
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