MEDICARE: ORLANDO URGENT CARE, 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
1	207Q00000X	Family Medicine Physician	4119	FL

General Provider Information

NPI Number	:	1447621362
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORLANDO URGENT CARE, LLC

Provider Business Mailing Address
First Line	:	2700 OLD WINTER GARDEN RD
Second Line	:
City	:	OCOEE
State	:	FL
Zip	:	34761-2964
Country	:	US
Telephone Number	:	407-253-7850
Fax Number	:	407-656-4177

Provider Business Practice Location Address
First Line	:	2700 OLD WINTER GARDEN RD
Second Line	:
City	:	OCOEE
State	:	FL
Zip	:	34761-2964
Country	:	US
Telephone Number	:	407-253-7850
Fax Number	:	407-656-4177

Authorized Official
Title or Position	:	CFO
Name	:	MICHAEL MUELLER
Credential	:
Telephone Number	:	407-296-1000

Provider Enumeration Date	:	10/19/2015
Last Update Date	:	01/15/2016

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