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General NPI Number Information
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NPI Number | 1770909152
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Entity Type | Organization
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Legal Business Name | WINTER GARDEN URGENT CARE, LLC
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Dates
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Enumeration Date | 03/10/2014
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Last Update Date | 07/31/2014
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Provider Practice Location Address
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Address Line | 736 S DILLARD ST UNIT A
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City | WINTER GARDEN
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State | FL
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Zip | 34787-3908
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Country | US
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Telephone | 407-656-0505
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Fax | 407-656-0505
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Provider Business Mailing Address
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Address Line | 736 S DILLARD ST UNIT A
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City | WINTER GARDEN
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State | FL
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Zip | 34787-3908
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Country | US
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Telephone | 407-656-7000
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Fax | 407-656-7005
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Authorized Official
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Title or Position | MGR
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Name | HARBINDER GHULLDU
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Credential | MD
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Telephone | 407-370-9783
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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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