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NPI Code Detail

MEDICARE: URGENT CARE CENTER OF LONGWOOD LLC

MEDICARE: URGENT CARE CENTER OF LONGWOOD LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QU0200XUrgent Care Clinic/CenterFL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1247855139OTHERFLURGENT CARE-ACHA EXEMPT

General Provider Information

NPI Number : 1093905986
Entity Type Code : Organization
Provider Name (Legal Business Name) : URGENT CARE CENTER OF LONGWOOD LLC
Provider Business Mailing Address
First Line : 450 W STATE ROAD 434 STE 1010
Second Line :
City : LONGWOOD
State : FL
Zip : 32750-5187
Country : US
Telephone Number : 407-212-3000
Fax Number : 407-212-3001
Provider Business Practice Location Address
First Line : 450 W STATE ROAD 434 STE 1010
Second Line :
City : LONGWOOD
State : FL
Zip : 32750-5187
Country : US
Telephone Number : 407-212-3000
Fax Number : 407-212-3001
Authorized Official
Title or Position : OWNER
Name : DR. WASIM AHMAR
Credential : MD
Telephone Number : 407-212-3000
Provider Enumeration Date : 07/27/2007
Last Update Date : 08/12/2020

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Directions to “URGENT CARE CENTER OF LONGWOOD LLC ” Practice Location

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